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Sample records for twelve patients died

  1. Psychotherapy of the dying patient.

    Science.gov (United States)

    Stedeford, A

    1979-07-01

    The psychotherapeutic aspects of the care of the 49 terminally ill patients described in the preceeding paper are discussed. Their differing ways of coping with the stress of dying and the range of psychotherapeutic strategies used in treatment are described. The work suggests that the therapist's use of psychological insights can improve his understanding of the emotional pain of terminal illness, and well-aimed psychotherapy can contribute to its relief.

  2. Hyperinsulinism and hyperammonemia syndrome: report of twelve unrelated patients.

    Science.gov (United States)

    De Lonlay, P; Benelli, C; Fouque, F; Ganguly, A; Aral, B; Dionisi-Vici, C; Touati, G; Heinrichs, C; Rabier, D; Kamoun, P; Robert, J J; Stanley, C; Saudubray, J M

    2001-09-01

    Hyperinsulinism and hyperammonemia syndrome has been reported as a cause of moderately severe hyperinsulinism with diffuse involvement of the pancreas. The disorder is caused by gain of function mutations in the GLUD1 gene, resulting in a decreased inhibitory effect of guanosine triphosphate on the glutamate dehydrogenase (GDH) enzyme. Twelve unrelated patients (six males, six females) with hyperinsulinism and hyperammonemia syndrome have been investigated. The phenotypes were clinically heterogeneous, with neonatal and infancy-onset hypoglycemia and variable responsiveness to medical (diazoxide) and dietary (leucine-restricted diet) treatment. Hyperammonemia (90-200 micromol/L, normal carbamylglutamate administration. The patients had mean basal GDH activity (18.3 +/- 0.9 nmol/min/mg protein) not different from controls (17.9 +/- 1.8 nmol/min/mg protein) in cultured lymphoblasts. The sensitivity of GDH activity to inhibition by guanosine triphosphate was reduced in all patient lymphoblast cultures (IC(50), or concentrations required for 50% inhibition of GDH activity, ranging from 140 to 580 nM, compared with control IC(50) value of 83 +/- 1.0 nmol/L). The allosteric effect of ADP was within the normal range. The activating effect of leucine on GDH activity varied among the patients, with a significant decrease of sensitivity that was correlated with the negative clinical response to a leucine-restricted diet in plasma glucose levels in four patients. Molecular studies were performed in 11 patients. Heterozygous mutations were localized in the antenna region (four patients in exon 11, two patients in exon 12) as well as in the guanosine triphosphate binding site (two patients in exon 6, two patients in exon 7) of the GLUD1 gene. No mutation has been found in one patient after sequencing the exons 5-13 of the gene.

  3. Twelve novel Atm mutations identified in Chinese ataxia telangiectasia patients.

    Science.gov (United States)

    Huang, Yu; Yang, Lu; Wang, Jianchun; Yang, Fan; Xiao, Ying; Xia, Rongjun; Yuan, Xianhou; Yan, Mingshan

    2013-09-01

    Ataxia telangiectasia (A-T) is an autosomal recessive disease characterized mainly by progressive cerebellar ataxia, oculocutaneous telangiectasia, and immunodeficiency. This disease is caused by mutations of the ataxia telangiectasia mutated (Atm) gene. More than 500 Atm mutations that are responsible for A-T have been identified so far. However, there have been very few A-T cases reported in China, and only two Chinese A-T patients have undergone Atm gene analysis. In order to systemically investigate A-T in China and map their Atm mutation spectrum, we recruited eight Chinese A-T patients from six unrelated families nationwide. Using direct sequencing of genomic DNA and the multiplex ligation-dependent probe amplification, we identified twelve pathogenic Atm mutations, including one missense, four nonsense, five frameshift, one splicing, and one large genomic deletion. All the Atm mutations we identified were novel, and no homozygous mutation and founder-effect mutation were found. These results suggest that Atm mutations in Chinese populations are diverse and distinct largely from those in other ethnic areas.

  4. Understanding Dying Patients and Their Families

    Science.gov (United States)

    Librach, S.L.; Talbot, Yves

    1991-01-01

    Caring for dying patients and their families presents unique opportunities and challenges for the family physician. The family FIRO model provides a simple way of assessing families and providing appropriate, individualized care. This article outlines the model, discusses the care of dying patients and their families from the FIRO perspective, and provides a guideline for the family physician. A framework is suggested for teaching residents to support families. PMID:21228989

  5. Death and dying: what the patient wants.

    Science.gov (United States)

    Balducci, L

    2012-04-01

    A good death and a death with dignity may be achieved when death is congruent with the personal values of the patient. It behooves the practitioner to recognize these values and to cater to them. This paper describes effective communication with the dying person, and the partnership of treatment team, patient and family in face of the patient death. To identify and define the patient wishes it is necessary to learn how to interpret the patient's non verbal as often patients are unable to formulate the questions they wish to ask concerning their passing. These difficulties stem from several cultural factors including concern about disturbing the practitioner. It is the treatment team's responsibility to facilitate this discussion. A good death is achieved when symptoms are controlled and when patients and family recognize death as a unique living experience to be treasured as any other living experience. A death with dignity brings healing, that is always possible even when cure is out of reach. Patient's and practitioner's values may be at odd in face of controversial issues including euthanasia, assisted suicide and terminal sedation. Though he/she should not be compelled to execute these requests, the practitioner should be able to entertain an open discussion with the patient concerning these issues. Open communication and reflective listening even in presence of disagreements are the venue of healing. The study of death and dying requires novel approaches including personal narrative and qualitative research to complement traditional research instrument, such as questionnaire that cannot embrace the whole human dimension.

  6. [Palliative (symptomatic) care of (imminently) dying patients].

    Science.gov (United States)

    Hänninen, Juha; Hamunen, Katri; Laakkonen, Marja-Liisa; Laukkala, Tanja; Lehto, Juho; Matila, Ari; Rahko, Eeva; Saarto, Tiina; Tohmo, Harri; Vuorinen, Eero

    2013-01-01

    The updated Current Care Guideline focuses on medical symptom treatment when curative treatment is no longer possible. Palliative care should be available to all dying patients at all health care levels. Pain should be treated prophylactically. Opioids are effective in cancer pain and should be chosen for moderate or severe pain in line with the WHO pain ladder. Treatment options for symptoms which call for acute interventions, such as intracranial hypertension, and options for dyspnoea, delirium, gastro-intestinal symptoms, ascites, dehydration and end-of-life treatment of elderly and demented patients are described.

  7. Dying cancer patients talk about euthanasia.

    Science.gov (United States)

    Eliott, Jaklin A; Olver, Ian N

    2008-08-01

    Within developed nations, there is increasing public debate about and apparent endorsement of the appropriateness of euthanasia as an autonomous choice to die in the face of intolerable suffering. Surveys report socio-demographic differences in rates of acceptance of euthanasia, but there is little in-depth analysis of how euthanasia is understood and positioned within the social and moral lives of individuals, particularly those who might be considered suitable candidates-for example, terminally-ill cancer patients. During discussions with 28 such patients in Australia regarding medical decisions at the end of life, euthanasia was raised by 13 patients, with the others specifically asked about it. Twenty-four patients spoke positively of euthanasia, 19 of these voicing some concerns. None identified euthanasia as a currently favoured option. Four were completely against it. Endorsement for euthanasia was in the context of a hypothetical future or for a hypothetical other person, or temporally associated with acute pain. Arguments supporting euthanasia framed the issue as a matter of freedom of choice, as preserving dignity in death, and as curbing intolerable pain and suffering, both of the patient and of those around them. A common analogy featured was that of euthanising a dog. These arguments were typically presented as self-evident justification for euthanasia, construed as an appropriate choice to die, with opposers positioned as morally inferior or ignorant. The difficulties of ensuring 'choice' and the moral connotations of 'choosing to die,' however, worked to problematise the appropriateness of euthanising specific individuals. We recommend further empirical investigation of the moral and social meanings associated with euthanasia.

  8. Health care practitioners and dying patients

    Directory of Open Access Journals (Sweden)

    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.

  9. Nursing experience and the care of dying patients.

    Science.gov (United States)

    Dunn, Karen S; Otten, Cecilia; Stephens, Elizabeth

    2005-01-19

    To examine relationships among demographic variables and nurses attitudes toward death and caring for dying patients. Descriptive and correlational. Two metropolitan hospitals in Detroit, MI. 58 RNs practicing in oncology and medical/surgical nursing. The majority was female and white, with a mean age of 41 years. Completed survey of three measurement tools: a demographic survey, Frommelt Attitudes Toward Care of the Dying (FATCOD) Scale, and Death Attitude Profile Revised (DAP-R) Scale. Of 60 surveys distributed, 58 were completed and returned. Past experiences (level of education and death training), personal experiences (age, race, religion, and attitudes toward death), professional experiences (months or years of nursing experience and the percentage of time spent in contact with terminally ill or dying patients), and attitudes toward caring for dying patients. Most respondents demonstrated a positive attitude about caring for dying patients. Nurses who reported spending a higher percentage of time in contact with terminally ill or dying patients reported more positive attitudes. No significant relationship was found between nurses attitudes toward death and nurses attitudes about caring for dying patients. Statistically significant relationships were found among certain demographic variables, DAP-R subscales, and FATCOD Scale. Regardless of how the nurses felt about death, providing professional and quality care to dying patients and their families was salient. Developing continuing education programs that teach effective coping strategies to prevent death anxiety and identifying barriers that can make caring for dying patients difficult may make the journey from novice to expert nurse a gratifying and rewarding experience.

  10. Die neue Psychosomatik: Auswirkungen des Paradigmenwechsels auf die Betreuung von CED-PatientInnen

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    Weiss P

    2004-01-01

    Full Text Available In den letzten Jahren erfolgte ein radikaler Wandel in der psychosomatischen Forschung bei CED. Die Evidenz-basierte Datenlage wird anhand der Konsensusempfehlungen der DGSV und der ÖGGH ausführlich beschrieben. Die aktuellen Forschungsansätze werden kritisch beleuchtet. Ein Stufenmodell unter Einschluß der ÄrztInnen für Allgemeinmedizin, FachärztInnen, Spezialambulanzen, psychosomatischen C/L-Diensten und spezialisierten Abteilungen ermöglicht eine differenzierte psychosomatische Betreuung von PatientInnen mit CED.

  11. Nurses’ Caring Behaviors for Dying Patients in Southern Thailand

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    Chuleeporn Prompahakul

    2011-07-01

    Full Text Available Background: Nowadays, the end-of-life care becomes an indicator of the quality of care in a hospital. However, current nursing standards and quality of care related to the end of life do not meet the desired expectations of both dying patients and their families. Therefore, caring behaviors of nurses need to be described.Purpose: The purpose of this descriptive research was to describe the level of nurses’ caring behaviors for dying patients in southern Thailand. Method: Proportionate stratified random sampling was used to select 360 registered nurses who had been working in general hospitals and regional/university hospitals in southern Thailand for at least one year. Instruments used in the study included the Demographic Data Questionnaire (DDQ and the Nurse’s Caring Behavior for Dying Patients Questionnaire (NCBDQ. The questionnaires were content validated by three experts. The reliability of the NCBDQ was tested with 30 nurses yielding a Cronbach’s alpha coefficient of .97. The data were analyzed by using frequency, percentage, mean and standard deviation.Results: The level of nurses’ caring behaviors for dying patients was high (M = 2.12, SD = .43. The five dimensions of the nurses' caring behaviors including compassion, confidence, conscience, commitment and comportment were also at a high level. However, the competence dimension was at a moderate level (M = 1.82, SD = .51. Conclusion: The results of this study indicated that nurses perceived themselves as having a moderate level of competency in taking care of dying patients. Therefore, educational intervention on enhancing nurses’ competency for end of life care is recommended. In addition, factors relating to nurses’ caring behavior for dying patients should be further explored.Keywords: caring behaviors, dying patients, nurses, southern Thailand

  12. Patients who die during palliative radiotherapy. Status survey

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    Berger, B.; Ankele, H.; Bamberg, M.; Zips, D. [University of Tuebingen, Department of Radiation Oncology, Tuebingen (Germany)

    2014-02-15

    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.) [German] Die palliative Radiotherapie (RT) hat einen hohen Stellenwert in der Symptomenkontrolle terminal erkrankter Tumorpatienten. Unnoetig belastende Therapien kurz vor Lebensende sollten jedoch vermieden werden. Bislang gibt es kaum strukturierte Daten ueber Sterbefaelle unter palliativer RT. Im Rahmen der vorgestellten Studie wurden die Sterbefaelle unter stationaer palliativ bestrahlten Patienten der eigenen Abteilung zwischen Januar 2009 und Dezember 2011 analysiert. Ausgewertet wurden epidemiologische Faktoren, Behandlungskonzept und -verlauf. Zeit bis zum RT-Beginn und RT-Dauer wurden ins Verhaeltnis zur tatsaechlichen

  13. Dying with dignity: the good patient versus the good death.

    Science.gov (United States)

    Proulx, Kathryn; Jacelon, Cynthia

    2004-01-01

    Death is a unique experience for each human being, yet there is tremendous societal pressure on a dying person to be a "goodpatient " while trying to experience the "good death. " These pressures shape patient, caregiver, and family choices in end-of-life situations. The purpose of this literature review was twofold: first, to develop an understanding of "dying with dignity" to enhance the end-of-life care received by dying patients, and second, to contribute to a concept analysis of dignity to improve the clarity and consistency of future research related to dignity in aging individuals. Articles pertaining to dying with dignity from the disciplines of nursing, medicine, ethics, psychology, and sociology were reviewed using a matrix method. A dichotomy surrounding dying with dignity emerged from this review. The definition of dignity in dying identifies not only an intrinsic, unconditional quality of human worth, but also the external qualities of physical comfort, autonomy, meaningfulness, usefulness, preparedness, and interpersonal connection. For many elderly individuals, death is a process, rather than a moment in time, resting on a need for balance between the technology of science and the transcendence of spirituality.

  14. Acronyms of dying versus patient autonomy.

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    Salkić, Amina; Zwick, Anna

    2012-06-01

    In medical practice in Germany and several other countries abbreviated orders linked to end-of-life decisions, such as DNR (do not resuscitate), are increasingly used. In order to investigate their legal status, this article gives an overview of the recently passed German law, which regulates the process of end-of-life decision-making and the use of living wills, giving primacy to patient autonomy. Concerning the risk of misinterpretation of acronyms, the article describes the impacts of such orders on patient autonomy and safety and suggests a clear systematic classification of the different DNR orders in order to investigate their legal status under the German law. Their general binding force is to be acknowledged, depending on its origination and the fulfilment of certain requirements.

  15. Identifying admitted patients at risk of dying

    DEFF Research Database (Denmark)

    Brabrand, Mikkel; Knudsen, Torben; Hallas, Jesper

    2013-01-01

    Risk assessment is an important part of emergency patient care. Risk assessment tools based on biochemical data have the advantage that calculation can be automated and results can be easily provided. However, to be used clinically, existing tools have to be validated by independent researchers....... This study involved an independent external validation of four risk stratification systems predicting death that rely primarily on biochemical variables....

  16. Phenomenological study of ICU nurses' experiences caring for dying patients.

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    King, Phyllis Ann; Thomas, Sandra P

    2013-11-01

    This existential phenomenological study explored caring for the dying based on the philosophical works of Merleau-Ponty. Fourteen critical care nurses were asked to describe lived experiences of caring for dying patients. An encompassing theme of Promises to Keep emerged, with five subthemes, including the following: (a) promise to be truthful: "Nurses are in the game of reality," (b) promise to provide comfort: "I'll make him comfortable," (c) promise to be an advocate: "Just one more day," (d) "Promise that couldn't be kept," and (e) "Promise to remain connected." The essence of intensive care nurses' lived experience of caring for dying patients is captured in the theme Promises to Keep. Nurses accept the reality of death and express strong commitment to making it as comfortable, peaceful, and dignified as possible, despite critical care unit environments that foster a "paradigm of curing" rather than a "paradigm of caring.".

  17. Care and Quality of Life in the Dying Phase: The contribution of the Liverpool Care Pathway for the Dying Patient

    NARCIS (Netherlands)

    L. Veerbeek (Laetitia)

    2008-01-01

    textabstractThis thesis concerns the professional care and the quality of life for dying patients and their relatives in the hospital, the nursing home and the primary care setting. The effect of introducing the Liverpool Care Pathway for the Dying Patient (LCP) on the content of care and the qualit

  18. Comparing quality of dying and death perceived by family members and nurses for patients dying in US and Dutch ICUs

    DEFF Research Database (Denmark)

    Gerritsen, Rik T; Koopmans, Matty; Hofhuis, José G M

    2017-01-01

    BACKGROUND: The Quality of Dying and Death (QODD) questionnaire is used as a self-reported measure to allow families and clinicians to assess patients' quality of dying and death. We evaluated end-of-life (EOL) experiences as measured by the QODD completed by families and nurses in the United...... States (US) and the Netherlands (NL) to explore similarities and differences in these experiences and identify opportunities for improving EOL care. METHODS: Questionnaire data were gathered from family members of patients dying in the ICU and nurses caring for these patients. In NL, data were gathered.......0025). The family-assessed overall QODD score (medians [IQR]) was the same in both countries: NL 9 [8-10], US 8[5-10]. US family members rated the quality of two items higher than NL families: "time spent with loved ones" and "time spent alone". Nurse-assessed QODD ratings varied: the single-item QODD summary score...

  19. Deathbed wills: assessing testamentary capacity in the dying patient.

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    Peisah, C; Luxenberg, J; Liptzin, B; Wand, A P; Shulman, K; Finkel, S

    2014-02-01

    Deathbed wills by their nature are susceptible to challenge. Clinicians are frequently invited to give expert opinion about a dying testator's testamentary capacity and/or vulnerability to undue influence either contemporaneously, when the will is made, or retrospectively upon a subsequent challenge, yet there is minimal discourse in this area to assist practice. The IPA Capacity Taskforce explored the issue of deathbed wills to provide clinicians with an approach to the assessment of testamentary capacity at the end of life. A systematic review searching PubMed and Medline using the terms: "deathbed and wills," "deathbed and testamentary capacity," and "dying and testamentary capacity" yielded one English-language paper. A search of the individual terms "testamentary capacity" and "deathbed" yielded one additional relevant paper. A focused selective review was conducted using these papers and related terms such as "delirium and palliative care." We present two cases to illustrate the key issues here. Dying testators are vulnerable to delirium and other physical and psychological comorbidities. Delirium, highly prevalent amongst terminal patients and manifesting as either a hyperactive or hypoactive state, is commonly missed and poorly documented. Whether the person has testamentary capacity depends on whether they satisfy the Banks v Goodfellow legal criteria and whether they are free from undue influence. Regardless of the clinical diagnosis, the ultimate question is can the testator execute a specific will with due consideration to its complexity and the person's circumstances? Dual ethical principles of promoting autonomy of older people with mental disorders whilst protecting them against abuse and exploitation are at stake here. To date, there has been scant discourse in the scientific literature regarding this issue.

  20. Hope beyond (redundant) hope: how chaplains work with dying patients.

    Science.gov (United States)

    Nolan, Steve

    2011-01-01

    Using Grounded Theory, this study examines the experience of 19 palliative care chaplains in counselling dying people. Taking a broad-based definition of counselling, and using unstructured individual interviews and group work, the study aimed to understand how palliative care chaplains work with patients at the point when it has been decided to cease active treatment, the point where they risk losing hope and falling into despair. Analysing the data using code-based theory building software, the author identified four organic moments in the chaplain-patient relationship, each moment being a discernable development in the chaplain's being-with the patient: 'evocative presence'; 'accompanying presence'; 'comforting presence'; and 'hopeful presence'. The author represents the four moments as a theory of 'chaplain as hopeful presence', and offers a description of the way in which the quality of presence can facilitate patients to develop 'a hopeful manner' in which hope is reconfigured into an attribute of being. The author concludes (with Levinas) that chaplains and other palliative care staff should be aware that simply being-with an other can, in itself, be hope fostering.

  1. Factors influencing attitude toward care of dying patients in first-year nursing students.

    Science.gov (United States)

    Hagelin, Carina Lundh; Melin-Johansson, Christina; Henoch, Ingela; Bergh, Ingrid; Ek, Kristina; Hammarlund, Kina; Prahl, Charlotte; Strang, Susann; Westin, Lars; Österlind, Jane; Browall, Maria

    2016-01-01

    To describe Swedish first-year undergraduate nursing students' attitudes toward care of dying patients. Possible influences such as age, earlier care experiences, care education, experiences of meeting dying patients and place of birth were investigated. The Frommelt Attitude Toward Care of the Dying Scale (FATCOD) was used in six universities. Descriptive statistics and regression analysis were used. Some 371 students (67.3%) reported overall positive attitude toward caring for dying patients (total mean FATCOD 119.5, SD 10.6) early in their first semester. Older students, students with both earlier care experience and earlier education, those with experience of meeting a dying person, and students born in Sweden reported the highest scores, a more positive attitude. Age, earlier care experience and education, experiences of meeting a dying person and place of birth seems to affect students' attitudes toward care of the dying and need to be considered among nursing educators.

  2. Branding your practice: twelve practical steps to creating lifelong patient relationships.

    Science.gov (United States)

    Neely, Melinda Hinson

    2005-01-01

    The concept of branding is not limited to large companies. It can be successfully applied in medical practices to those individuals or groups that wish to establish a distinct identity in the marketplace. Branding a medical practice establishes a competitive advantage, ensures a more predictable flow of patients, and ultimately enhances patient satisfaction. This article conceptualizes the branding process and provides guidelines for implementation that are applicable to a variety of budgets.

  3. Twelve tips for better communication with patients during history-taking.

    Science.gov (United States)

    Rahman, Aminur; Tasnim, Saria

    2007-04-30

    Eliciting proper history from a patient is of paramount importance to establish an accurate diagnosis and management in medical practice. Good communication skill is a prerequisite for an effective physician patient relationship. A systematic search of medical literature has been made to formulate a guideline for better communication during history taking. The guideline emphasizes on both physical environment and emotional encounter and the key points are expressed as tips on relevant issues.

  4. Twelve Tips for Better Communication with Patients During History-Taking

    Directory of Open Access Journals (Sweden)

    Aminur Rahman

    2007-01-01

    Full Text Available Eliciting proper history from a patient is of paramount importance to establish an accurate diagnosis and management in medical practice. Good communication skill is a prerequisite for an effective physician patient relationship. A systematic search of medical literature has been made to formulate a guideline for better communication during history taking. The guideline emphasizes on both physical environment and emotional encounter and the key points are expressed as tips on relevant issues.

  5. Etodolac, aspirin, and placebo in patients with degenerative joint disease: a twelve-week study.

    Science.gov (United States)

    Andelman, S Y

    1983-01-01

    Thirty patients from a private practice were enrolled in an investigation designed to compare the efficacy and safety of a new nonsteroidal anti-inflammatory drug, etodolac, with those of aspirin and placebo in ameliorating pain, inflammation, and functional deficits associated with degenerative joint disease. The 12-week, double-blind, parallel-group study was divided into drug-titration and maintenance periods and was preceded by a washout period of up to two weeks. There were ten patients in each of the three treatment groups. The mean daily maintenance dosages of etodolac and aspirin were 384 mg and 4,322 mg, respectively. Etodolac was significantly (less than or equal to 0.05) more effective than placebo according to 11 of 15 clinical indexes of efficacy: three assessments of the range of motion of the knee joint, and one each of pain while standing, pain while walking, pain while climbing stairs, the average of pains while bearing weight, pain at night, joint tenderness, patient's self-evaluation, and the time required to walk 50 feet. Aspirin was significantly more effective than placebo in only three assessments: two of the range of motion of the knee joint and one of pain while standing. One patient taking etodolac, three patients taking aspirin, and six patients taking placebo withdrew from the trial because of insufficient therapeutic response. There were four withdrawals due to adverse effects, two in the aspirin group and two in the placebo group. Adverse effects (tinnitus and hearing loss) leading to withdrawal of one of the two aspirin patients were probably due to drug administration. No significant side effects were reported by patients in the etodolac group.

  6. Altered Lipid Metabolism in Recovered SARS Patients Twelve Years after Infection.

    Science.gov (United States)

    Wu, Qi; Zhou, Lina; Sun, Xin; Yan, Zhongfang; Hu, Chunxiu; Wu, Junping; Xu, Long; Li, Xue; Liu, Huiling; Yin, Peiyuan; Li, Kuan; Zhao, Jieyu; Li, Yanli; Wang, Xiaolin; Li, Yu; Zhang, Qiuyang; Xu, Guowang; Chen, Huaiyong

    2017-08-22

    Severe acute respiratory syndrome-coronavirus (SARS-CoV) and SARS-like coronavirus are a potential threat to global health. However, reviews of the long-term effects of clinical treatments in SARS patients are lacking. Here a total of 25 recovered SARS patients were recruited 12 years after infection. Clinical questionnaire responses and examination findings indicated that the patients had experienced various diseases, including lung susceptibility to infections, tumors, cardiovascular disorders, and abnormal glucose metabolism. As compared to healthy controls, metabolomic analyses identified significant differences in the serum metabolomes of SARS survivors. The most significant metabolic disruptions were the comprehensive increase of phosphatidylinositol and lysophospha tidylinositol levels in recovered SARS patients, which coincided with the effect of methylprednisolone administration investigated further in the steroid treated non-SARS patients with severe pneumonia. These results suggested that high-dose pulses of methylprednisolone might cause long-term systemic damage associated with serum metabolic alterations. The present study provided information for an improved understanding of coronavirus-associated pathologies, which might permit further optimization of clinical treatments.

  7. Surgical treatment of aneurysms of the ascending aorta. Twelve years' experience in 66 patients.

    Science.gov (United States)

    Markewitz, A; Weinhold, C; Kemkes, B M; Reichart, B; Hemmer, W; Klinner, W

    1986-10-01

    This study presents the results in 66 patients undergoing surgery for concomitant supracoronary vascular interposition and valve replacement carried out at the Department of Cardiac Surgery of the University of Munich, West-Germany, over a period of 12 years (from July 1, 1973 to June 30, 1985) using a technique similar to that described by Wheat. Forty-seven percent of the cases were true aneurysms and 20% chronic dissections. Thirty-three percent of patients had acute dissections. Early mortality was 16% in the total patient population, 9% in the group having true aneurysm and 32% in the group having acute dissection. No early death was observed in association with chronic dissections. The actuarial one-year survival rate in patients with true aneurysm or chronic dissection was 83.6%, and 54.1% in patients with acute dissection. The corresponding 4-year survival rates were 76.4% and 54.1%, respectively. The average improvement according to the New York Heart Association classification was 1.5 grades. These results confirm that the operative approach to ascending aortic aneurysms is superior to medical treatment, with the operative method involving vascular graft without concomitant aortic valve replacement as well as the method described by Wheat having both proved successful.

  8. Cytogenetic studies in twelve patients with primary myelofibrosis and myeloid metaplasia.

    Science.gov (United States)

    Smadja, N; Krulik, M; de Gramont, A; Sirinelli, A; Brissaud, P; Dray, C; Audebert, A A; Debray, J

    1987-01-01

    Chromosome studies on bone marrow and/or peripheral blood cells without phytohemagglutinin were performed on 12 patients with primary myelofibrosis with myeloid meta-plasia (PMMM) between 1980 and 1984. Abnormal clones were found in six patients (50%). In five cases the abnormal clone involved the long arm of chromosome #7, two of which also had partial trisomy of chromosome #1 and trisomy of 9. Additional abnormalities involving chromosomes #3, #5, #11, #13, #15, and #21 were each found once. Review of the literature showed few studies on the cytogenetics of PMMM. No specific chromosomal pattern can be established; however, abnormalities described are nonrandom.

  9. Twelve-Month and Lifetime Prevalence of Mental Disorders in Cancer Patients.

    Science.gov (United States)

    Kuhnt, Susanne; Brähler, Elmar; Faller, Hermann; Härter, Martin; Keller, Monika; Schulz, Holger; Wegscheider, Karl; Weis, Joachim; Boehncke, Anna; Hund, Bianca; Reuter, Katrin; Richard, Matthias; Sehner, Susanne; Wittchen, Hans-Ulrich; Koch, Uwe; Mehnert, Anja

    2016-01-01

    Psychological problems are common in cancer patients. For the purpose of planning psycho-oncological interventions and services tailored to the specific needs of different cancer patient populations, it is necessary to know to what extent psychological problems meet the criteria of mental disorders. The purpose of this study was to estimate the 12-month and lifetime prevalence rates of mental disorders in cancer patients. A representative sample of patients with different tumour entities and tumour stages (n = 2,141) in outpatient, inpatient and rehabilitation settings underwent the standardized computer-assisted Composite International Diagnostic Interview for mental disorders adapted for cancer patients (CIDI-O). The overall 12-month prevalence for any mental disorder was 39.4% (95% CI: 37.3-41.5), that for anxiety disorders was 15.8% (95% CI: 14.4-17.4), 12.5% (95% CI: 11.3-14.0) for mood disorders, 9.5% (95% CI: 8.3-10.9) for somatoform disorders, 7.3% (95% CI: 6.2-8.5) for nicotine dependence, 3.7% (95% CI: 3.0-4.6) for disorders due to general medical condition, and 1.1% (95% CI: 0.7-1.6) for alcohol abuse or dependence. Lifetime prevalence for any mental disorder was 56.3% (95% CI 54.1-58.6), that for anxiety disorders was 24.1% (95% CI: 22.3-25.9), 20.5% (95% CI: 18.9-22.3) for mood disorders, 19.9% (95% CI: 18.3-21.7) for somatoform disorders, 18.2% (95% CI: 16.6-20.0) for nicotine dependence, 6.4% (95% CI: 5.4-7.6) for alcohol abuse or dependence, 4.6% (95% CI: 3.8-5.6) for disorders due to general medical condition, and 0.2% (95% CI: 0.1-0.6) for eating disorders. Mental disorders are highly prevalent in cancer patients, indicating the need for provision of continuous psycho-oncological support from inpatient to outpatient care, leading to an appropriate allocation of direct personnel and other resources. © 2016 S. Karger AG, Basel.

  10. An evaluation of the resistance to flow through the patient valves of twelve adult manual resuscitators.

    Science.gov (United States)

    Hess, D; Simmons, M

    1992-05-01

    What is the inspiratory and expiratory resistance to flow through the patient valves of adult manual resuscitators? We evaluated the resistance to flow through the patient valves of 12 adult resuscitators (Ambu, Code Blue, DMR, Hope 4, Hospitak, Hudson, Intertech, Laerdal, Mercury, Respironics, SPUR, Vitalograph). Expiratory resistance was evaluated by directing a flow of oxygen through the valve in the direction that the patient expires. Inspiratory resistance was evaluated by directing oxygen through the valve in the direction of flow when the bag is squeezed. Flow was controlled by a Timeter 0-75 flowmeter, and measured using a calibrated Timeter RT-200. Flows of 10, 20, 30, 40, 50, 60, 70, 80, and 90 L/min were used. Resistive back pressure of the resuscitator valves was measured using a calibrated Timeter RT-200. Resistance was calculated by dividing back pressure by flow. Five measurements were made at each flow setting for each resuscitator. Significant differences in back pressures and resistances existed between the resuscitators for both expiratory and inspiratory flows (p less than 0.001 in each case). Significant interaction effects also existed between resuscitator brands and flows (p less than 0.001 in each case). At an expiratory flow of 50 L/min, all resuscitators except the Hospitak and Vitalograph produced a back pressure less than 5 cm H2O (the International Standards Organization standard). At an inspiratory flow of 50 L/min, all resuscitators but the Hospitak, Mercury, and Vitalograph produced a back pressure less than 5 cm H2O. Significant differences existed in the back pressures produced due to the flow resistance through the patient valves of these resuscitators, and these might be considered excessive in some cases. Because this was a bench study, further work is needed to determine the clinical importance of these findings.

  11. Twelve tips to support the development of clinical reasoning skills using virtual patient cases.

    Science.gov (United States)

    Posel, Nancy; Mcgee, James B; Fleiszer, David M

    2015-01-01

    Clinical reasoning is a critical core competency in medical education. Strategies to support the development of clinical reasoning skills have focused on methodologies used in traditional settings, including lectures, small groups, activities within Simulation Centers and the clinical arena. However, the evolving role and growing utilization of virtual patients (VPs) in undergraduate medical education; as well as an increased emphasis on blended learning, multi-modal models that include VPs in core curricula; suggest a growing requirement for strategies or guidelines that directly focus on VPs. The authors have developed 12 practical tips that can be used in VP cases to support the development of clinical reasoning. These are based on teaching strategies and principles of instructional design and pedagogy, already used to teach and assess clinical reasoning in other settings. Their application within VPs will support educators who author or use VP cases that promote the development of clinical reasoning.

  12. Caring for dying patients: Attitude of nursing students and effects of education

    Directory of Open Access Journals (Sweden)

    Mojtaba Jafari

    2015-01-01

    Full Text Available Background: Education about caring for dying patients could be effective in changing nursing students′ attitude toward caring for dying patients. Aim: The aim of the present study was to examine the nursing students′ attitude toward caring for dying patients and effects of education on their attitude. Materials and Methods: The present study enjoys a quasi-experimental method with using one-group pre-test/post-test design conducted in Bam in southeast of Iran. The attitude of nursing students was measured using Frommelt Attitude Toward Care of the Dying (FATCOD scale before and after an educational intervention. Data were analyzed using non-parametric tests in Statistical Package for the Social Sciences (SPSS 18 software. Results: Of 32 students, 30 participated in this study (response rate of 94%. Only 20% of the students reported previous experience of dying patients in their clinical courses. Students showed moderately negative to neutral attitudes toward caring for dying patients. Education has improved students′ attitude significantly (mean score of FATCOD before study were 3.5 ± 0.43 and after intervention were 4.7 ± 0.33 ( P < 0.001. Conclusion: Educational programs about death and caring for dying patients should be added to undergraduate nursing curricula. Further research recommended examining nursing students′ knowledge about caring for dying patients and the effect of education on their knowledge.

  13. To Chew, or Not to Chew? Patient Dies After Chewing Medication

    Science.gov (United States)

    ... OR NOT TO CHEW? PATIENT DIES AFTER CHEWING MEDICATION Some medications should never be chewed, cut, crushed, or diluted. ... instructions or do not question how to take medication. An 83-year-old patient was given Cardizem ...

  14. Comparing Quality of Dying and Death Perceived by Family Members and Nurses for Patients Dying in US and Dutch ICUs.

    Science.gov (United States)

    Gerritsen, Rik T; Koopmans, Matty; Hofhuis, José G M; Curtis, J Randall; Jensen, Hanne Irene; Zijlstra, Jan G; Engelberg, Ruth A; Spronk, Peter E

    2017-02-01

    The Quality of Dying and Death (QODD) questionnaire is used as a self-reported measure to allow families and clinicians to assess patients' quality of dying and death. We evaluated end-of-life (EOL) experiences as measured by the QODD completed by families and nurses in the United States and the Netherlands to explore similarities and differences in these experiences and identify opportunities for improving EOL care. Questionnaire data were gathered from family members of patients dying in the ICU and nurses caring for these patients. In The Netherlands, data were gathered in three teaching hospitals, and data was gathered from 12 sites participating in a randomized trial in the United States. The QODD consists of 25 items and has been validated in the United States. Data from 446 patients were analyzed (346 in the United States and 100 in the Netherlands). Dutch patients were older than those in the United States (72 + 10.2 years vs 65 + 16.0 years; P Nurse-assessed QODD ratings varied: the single-item QODD summary score was significantly higher in the Netherlands (the Netherlands: median, 9; IQR, 8-10 vs the United States: median, 7; IQR, 5-8; P nurse-assessed items, 10 were significantly different between the Netherlands and the United States, with eight having higher scores in the United States and 2 having higher scores in the Netherlands. The QODD was rated similarly by family members in the United States and the Netherlands but varied when assessed by nurses. These differences may be due to organizational or cultural differences between the two countries or to expectations of respondents. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Prevalence of depression and anxiety in patients requesting physicians’ aid in dying: cross sectional survey

    OpenAIRE

    Ganzini, Linda; Goy, Elizabeth R; Dobscha, Steven K.

    2008-01-01

    Objective To determine the prevalence of depression and anxiety in terminally ill patients pursuing aid in dying from physicians. Design Cross sectional survey. Setting State of Oregon, USA. Participants 58 Oregonians, most terminally ill with cancer or amyotrophic lateral sclerosis, who had either requested aid in dying from a physician or contacted an aid in dying advocacy organisation. Main outcome measures Diagnosis of depression or anxiety according to the hospital anxiety and depression...

  16. Twelve novel HGD gene variants identified in 99 alkaptonuria patients: focus on 'black bone disease' in Italy.

    Science.gov (United States)

    Nemethova, Martina; Radvanszky, Jan; Kadasi, Ludevit; Ascher, David B; Pires, Douglas E V; Blundell, Tom L; Porfirio, Berardino; Mannoni, Alessandro; Santucci, Annalisa; Milucci, Lia; Sestini, Silvia; Biolcati, Gianfranco; Sorge, Fiammetta; Aurizi, Caterina; Aquaron, Robert; Alsbou, Mohammed; Lourenço, Charles Marques; Ramadevi, Kanakasabapathi; Ranganath, Lakshminarayan R; Gallagher, James A; van Kan, Christa; Hall, Anthony K; Olsson, Birgitta; Sireau, Nicolas; Ayoob, Hana; Timmis, Oliver G; Sang, Kim-Hanh Le Quan; Genovese, Federica; Imrich, Richard; Rovensky, Jozef; Srinivasaraghavan, Rangan; Bharadwaj, Shruthi K; Spiegel, Ronen; Zatkova, Andrea

    2016-01-01

    Alkaptonuria (AKU) is an autosomal recessive disorder caused by mutations in homogentisate-1,2-dioxygenase (HGD) gene leading to the deficiency of HGD enzyme activity. The DevelopAKUre project is underway to test nitisinone as a specific treatment to counteract this derangement of the phenylalanine-tyrosine catabolic pathway. We analysed DNA of 40 AKU patients enrolled for SONIA1, the first study in DevelopAKUre, and of 59 other AKU patients sent to our laboratory for molecular diagnostics. We identified 12 novel DNA variants: one was identified in patients from Brazil (c.557T>A), Slovakia (c.500C>T) and France (c.440T>C), three in patients from India (c.469+6T>C, c.650-85A>G, c.158G>A), and six in patients from Italy (c.742A>G, c.614G>A, c.1057A>C, c.752G>A, c.119A>C, c.926G>T). Thus, the total number of potential AKU-causing variants found in 380 patients reported in the HGD mutation database is now 129. Using mCSM and DUET, computational approaches based on the protein 3D structure, the novel missense variants are predicted to affect the activity of the enzyme by three mechanisms: decrease of stability of individual protomers, disruption of protomer-protomer interactions or modification of residues in the region of the active site. We also present an overview of AKU in Italy, where so far about 60 AKU cases are known and DNA analysis has been reported for 34 of them. In this rather small group, 26 different HGD variants affecting function were described, indicating rather high heterogeneity. Twelve of these variants seem to be specific for Italy.

  17. Twelve novel HGD gene variants identified in 99 alkaptonuria patients: focus on ‘black bone disease' in Italy

    Science.gov (United States)

    Nemethova, Martina; Radvanszky, Jan; Kadasi, Ludevit; Ascher, David B; Pires, Douglas E V; Blundell, Tom L; Porfirio, Berardino; Mannoni, Alessandro; Santucci, Annalisa; Milucci, Lia; Sestini, Silvia; Biolcati, Gianfranco; Sorge, Fiammetta; Aurizi, Caterina; Aquaron, Robert; Alsbou, Mohammed; Marques Lourenço, Charles; Ramadevi, Kanakasabapathi; Ranganath, Lakshminarayan R; Gallagher, James A; van Kan, Christa; Hall, Anthony K; Olsson, Birgitta; Sireau, Nicolas; Ayoob, Hana; Timmis, Oliver G; Le Quan Sang, Kim-Hanh; Genovese, Federica; Imrich, Richard; Rovensky, Jozef; Srinivasaraghavan, Rangan; Bharadwaj, Shruthi K; Spiegel, Ronen; Zatkova, Andrea

    2016-01-01

    Alkaptonuria (AKU) is an autosomal recessive disorder caused by mutations in homogentisate-1,2-dioxygenase (HGD) gene leading to the deficiency of HGD enzyme activity. The DevelopAKUre project is underway to test nitisinone as a specific treatment to counteract this derangement of the phenylalanine-tyrosine catabolic pathway. We analysed DNA of 40 AKU patients enrolled for SONIA1, the first study in DevelopAKUre, and of 59 other AKU patients sent to our laboratory for molecular diagnostics. We identified 12 novel DNA variants: one was identified in patients from Brazil (c.557T>A), Slovakia (c.500C>T) and France (c.440T>C), three in patients from India (c.469+6T>C, c.650–85A>G, c.158G>A), and six in patients from Italy (c.742A>G, c.614G>A, c.1057A>C, c.752G>A, c.119A>C, c.926G>T). Thus, the total number of potential AKU-causing variants found in 380 patients reported in the HGD mutation database is now 129. Using mCSM and DUET, computational approaches based on the protein 3D structure, the novel missense variants are predicted to affect the activity of the enzyme by three mechanisms: decrease of stability of individual protomers, disruption of protomer-protomer interactions or modification of residues in the region of the active site. We also present an overview of AKU in Italy, where so far about 60 AKU cases are known and DNA analysis has been reported for 34 of them. In this rather small group, 26 different HGD variants affecting function were described, indicating rather high heterogeneity. Twelve of these variants seem to be specific for Italy. PMID:25804398

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

    Science.gov (United States)

    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 perceived by their relatives and (b) identify disease and care factors correlated with dying with dignity in HGG patients. We approached relatives of a cohort of 155 deceased HGG patients for the study. Participants completed a questionnaire concerning the EOL phase of the patient, covering several subthemes: (a) symptoms and signs, (b) health-related quality of life, (c) decision making, (d) place and quality of EOL care, and (e) dying with dignity. Relatives of 81 patients participated and 75% indicated that the patient died with dignity. These patients had fewer communication deficits, experienced fewer transitions between health care settings in the EOL phase, and more frequently died at their preferred place of death. Relatives were more satisfied with the physician providing EOL care and reported that the physician adequately explained treatment options. Multivariate analysis identified satisfaction with the physician, the ability to communicate, and the absence of transitions between settings as most predictive of a dignified death. Physicians caring for HGG patients in the EOL phase should timely focus on explaining possible treatment options, because patients experience communication deficits toward death. Physicians should strive to allow patients to die at their preferred place and avoid transitions during the last month of life.

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

    Science.gov (United States)

    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.

  20. 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

    INTRODUCTION: An important element in end-of-life care advocacy is to meet patients' end-of-life preferences. Most Scandinavian patients die in hospitals even though the majority prefers to die at home. Earlier studies have shown socio-economic differences in relation to dying at home, but more...... qualifies prior studies on preferences for end-of-life care and advocates for a more nuanced picture of the subject. Advocacy in end-of-life nursing recommends optimising active listening and communication skills striving towards more patients' preferences in all settings may be heard and fulfilled....... 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...

  1. Attitudes, subjective norms, and behavioral intentions of nurses toward dying patients and their families.

    Science.gov (United States)

    Waltman, N L

    1990-01-01

    This investigation aimed to develop and validate an instrument, "Attitudes, Subjective Norms, and Behavioral Intentions of Nurses Toward the Care of Dying Patients and Their Families" (ASBID), and to examine the relationship among selected demographic variables, death anxiety, and social desirability response tendency on the behavioral intentions of nurses toward the dying. The Ajzen-Fishbein theory of reasoned action was used as the conceptual framework. Nursing behaviors toward the dying included in the ASBID were developed from interviews with bereaved family members. Three hundred seventy-two registered nurses caring for dying patients were used as the sample population for testing the ASBID. Internal consistency reliability coefficients for the ASBID achieved satisfactory standards. Factor analysis suggested three factors were being measured: general acute care measures for the dying, open communication with the dying, and continuing care for bereaved family members. Results supported the Ajzen-Fishbein theory that attitudes and subjective norms were major determinants of intentions. Findings indicate that educational programs planned to influence nursing care of the dying should focus on the consequences of specific behaviors of nurses rather than on death anxiety in nurses, and they should include nursing supervisors as well as nurses providing direct care for the dying.

  2. Palliative care and circumstances of dying in German ALS patients using non-invasive ventilation.

    Science.gov (United States)

    Kühnlein, Peter; Kübler, Andrea; Raubold, Sabine; Worrell, Marcia; Kurt, Anja; Gdynia, Hans-Jürgen; Sperfeld, Anne-Dorte; Ludolph, Albert Christian

    2008-04-01

    Non-invasive ventilation (NIV) is known to improve quality of life and to prolong survival in amyotrophic lateral sclerosis (ALS) patients. However, little is known about the circumstances of dying in ventilated ALS patients. In the light of the debate on legalizing euthanasia it is important to provide empirical data about the process of dying in these patients. In a structured interview, 29 family caregivers of deceased ALS patients were asked about their own and the patient's attitude toward physician-assisted suicide (PAS) and euthanasia, circumstances of dying, and the use of palliative medication. Quantitative and qualitative content analysis was performed on the data. Non-recurring suicidal thoughts were reported by five patients. Three patients and seven relatives had thought about PAS. Seventeen caregivers described the patients' death as "peaceful", while choking was reported in six bulbar patients. In final stages of dying, the general practitioner (GP) was involved in the treatment of 10 patients, with palliative medication including sedatives and opiates being administered in eight cases. In conclusion, in contrast to the Netherlands, where 20% of terminal ALS patients die from PAS or euthanasia, only a small minority of our patients seems to have thought about PAS. The legal situation in Germany (where euthanasia is illegal), a bias due to the selection of NIV patients as well as a high percentage of religious patients and those with good levels of social support from family and friends, might account for this. Most of our patients died peacefully at home from carbon dioxide narcosis, but choking was described in some bulbar patients. Thus, palliative care, especially the use of opiates, anxiolytics and sedatives should be optimized, and the involvement of GP should be strongly encouraged, especially in bulbar patients.

  3. Understanding Dying Patients and Their Families: Using the family FIRO model.

    Science.gov (United States)

    Librach, S L; Talbot, Y

    1991-02-01

    Caring for dying patients and their families presents unique opportunities and challenges for the family physician. The family FIRO model provides a simple way of assessing families and providing appropriate, individualized care. This article outlines the model, discusses the care of dying patients and their families from the FIRO perspective, and provides a guideline for the family physician. A framework is suggested for teaching residents to support families.

  4. Effect of Blood-letting Puncture at Twelve Well-Points of Hand on Consciousness and Heart Rate in Patients with Apoplexy

    Institute of Scientific and Technical Information of China (English)

    Guo Yi; Wang Xiuyun; Xu Tangping; Dai Zhihua; Li Yunchen

    2005-01-01

    Objective: To observe the effect of blood-letting puncture at Twelve Well-Points of Hand on consciousness and heart rate in patients with early apoplexy. Method: Under observation were patients with disturbance of consciousness within 3 days after the apoplectic seizure. The patients were divided into a large injury team, a moderate injury team and a mild injury team. Each team was again randomly divided into a puncture group and a control group, with routine treatment in both groups but bloodletting puncture only in the puncture group. Quantitative changes in consciousness, blood pressure and heart rate of the patients were observed. Result: Blood-letting puncture at Twelve Well-Points of Hand can improve the consciousness and raise the systolic pressure in patients of the mild injury team, and accelerate the heart rate in all the patients in the puncture group. Conclusion: Blood-letting puncture at Twelve Well-Points of Hand can improve the consciousness of patients with brain injury in small area.

  5. Where to die? That is the question: A study of cancer patients in Israel.

    Science.gov (United States)

    Barak, Frida; Livshits, Sofia; Kaufer, Haana; Netanel, Ruth; Siegelmann-Danieli, Nava; Alkalay, Yasmin; Kreitler, Shulamith

    2015-04-01

    Most patients prefer to die at home, but barely 30% do so. This study examines the variables contributing to dying at home. The participants were 326 cancer patients, of both genders, with a mean age of 63.25 years, who died from 2000 to 2008 and were treated by the palliative care unit of the Barzilai Hospital. Some 65.7% died at home and 33.4% in a hospital. The data were extracted from patient files. The examined variables were demographic (e.g., age, gender, marital status, ethnic background, number of years in Israel until death), medical (e.g., age at diagnosis, diagnosis, nature of last treatment, patient received nursing care, patient given the care of a social worker, patient had care of a psychologist, family received care of a social worker, patient had a special caregiver), and sociological (e.g., having insurance, having worked in Israel, living alone or with family, living with one's children, living in self-owned or rented house, family members working). The findings indicate that the chances of dying at home are higher if the patient is non-Ashkenazi, the family got social worker care, the patient lived in a self-owned house, the patient lived with his family, the family members worked, and the patient's stay in Israel since immigration was longer. Logistic regression showed that all the predictors together yielded a significant model accounting for 10.9-12.3% of the variance. The findings suggest that dying at home requires maintaining continued care for the patient and family in a community context.

  6. 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).

  7. Fewer Heart Failure Patients Dying of Cardiac Arrest

    Science.gov (United States)

    ... new therapies. However, Fonarow isn't convinced that heart implants are no longer necessary for many patients. "Patients ... doctors have more time to decide whether an implant is needed for individual patients, added O'Connor, CEO of the Inova Heart and Vascular Institute in Falls Church, Va. He ...

  8. Symptoms, treatment and "dying peacefully" in terminally ill cancer patients: a prospective study

    NARCIS (Netherlands)

    Georges, J.J.; Philipsen, B.D.; Heide, van der A.; Wal, van der G.; Maas, van der P.J.

    2005-01-01

    GOALS: The aims of this study were to describe the symptoms, their treatment during the final months of life of terminally ill cancer patients and to assess characteristics of the dying process. PATIENTS AND METHODS: We used a prospective study design. From a representative sample of physicians who

  9. Are UK primary care teams formally identifying patients for palliative care before they die?

    Science.gov (United States)

    Harrison, Nadine; Cavers, Debbie; Campbell, Christine; Murray, Scott A

    2012-05-01

    The palliative care approach has the potential to improve care for patients with progressive life-threatening illnesses from the time of diagnosis. Policy and clinical directives in the UK advocate early identification. To determine the extent to which practices identify patients for palliative care, including factors influencing early identification and possible effects on place of death. Qualitative and quantitative data were collected from six general practices from three Scottish NHS boards and analysed. Records of patients who had died in the previous 6 months were analysed and interviews with practice staff (n = 21) and with patients currently on the practice palliative care register and bereaved relatives (n = 14) were conducted. In addition, a practice meeting was observed. In total, 29% of patients who died were recorded as being on the practice palliative care register before death. Two-thirds of patients with cancer were recorded on the register, but for those with non-malignant conditions only around 20% had any palliative care documented. This was a result of GPs not finding the current guidelines useful and being reluctant to discuss palliative care overtly with patients early in their illness. Palliative care services and documentation were geared towards patients with cancer. More district nurses than GPs saw the benefits of inclusion on the palliative care register. Only 25% of patients on the register died in hospital. Most patients with advanced progressive illnesses, especially those with non-malignant disease, are not being formally identified for a palliative care approach before they die. Those identified are more likely to benefit from coordinated care and may be more likely to die at home.

  10. Living with advanced chronic obstructive pulmonary disease: patients concerns regarding death and dying.

    Science.gov (United States)

    Gardiner, Clare; Gott, Merryn; Small, Neil; Payne, Sheila; Seamark, David; Barnes, Sarah; Halpin, David; Ruse, Charlotte

    2009-12-01

    Prognosis in COPD is poor and many patients perceive shortcomings in the education they receive about aspects of their condition. This study explores the experiences of patients with COPD, particularly fears surrounding death and dying. Semi-structured interviews were conducted with 21 patients with moderate or severe COPD. Findings revealed that patient understanding of COPD was poor, most patients were unaware of the progressive nature of the condition, and few were aware they could die of COPD. Despite this, patients often expressed concerns that their condition might deteriorate. Patients had particular concerns regarding the manner of their death; the overriding fear was dying of breathlessness or suffocation. None of the patients' had discussed these fears with a health care professional. Improved patient education is needed in order to improve patients understanding of their condition and prognosis. Open communication regarding death, as advocated in a palliative care approach, is also appropriate to alleviate patients fears and to allow them to make decisions regarding the management of their care at the end of life.

  11. [Care for the dying patient in emergency departments].

    Science.gov (United States)

    Iglesias, M L; Lafuente, A

    2010-01-01

    The aim of this article is to provide professionals in the hospital emergency departments with sufficient tools to face, according to the organisation and possibilities of each hospital, the admission of patients in the final days of life. It is primordial to provide a professional, technical and human environment based on concepts, attitudes and skills that make it possible to deal with the demands of comfort and the emotional and psycho-social requirements generated by these situations.

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

    Science.gov (United States)

    Eliott, Jaklin A.; Olver, Ian

    2011-01-01

    Abstract Background  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. Objective  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. Design and participants  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. Results  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. Conclusion  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. PMID:20860782

  13. Case study: an ethical dilemma involving a dying patient.

    Science.gov (United States)

    Pacsi, Alsacia L

    2008-01-01

    Nursing often deals with ethical dilemmas in the clinical arena. A case study demonstrates an ethical dilemma faced by healthcare providers who care for and treat Jehovah's Witnesses who are placed in a critical situation due to medical life-threatening situations. A 20-year-old, pregnant, Black Hispanic female presented to the Emergency Department (ED) in critical condition following a single-vehicle car accident. She exhibited signs and symptoms of internal bleeding and was advised to have a blood transfusion and emergency surgery in an attempt to save her and the fetus. She refused to accept blood or blood products and rejected the surgery as well. Her refusal was based on a fear of blood transfusion due to her belief in Bible scripture. The ethical dilemma presented is whether to respect the patient's autonomy and compromise standards of care or ignore the patient's wishes in an attempt to save her life. This paper presents the clinical case, identifies the ethical dilemma, and discusses virtue ethical theory and principles that apply to this situation.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. 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)

  17. Oncology Nursing Education: Nursing Students' Commitment of "Presence" with the Dying Patient and the Family.

    Science.gov (United States)

    Walsh, Sandra M.; Hogan, Nancy S.

    2003-01-01

    Following a chaplain's lecture on the end of life, nursing students wrote reaction papers on appropriate ways to support dying patients and their families. Six processes emerged, including the core concept of the nurse's presence at the bedside. (Contains 23 references.) (SK)

  18. Does withdrawing life-sustaining treatment cause death or allow the patient to die?

    Science.gov (United States)

    McGee, Andrew

    2014-01-01

    This article discusses recent arguments of Franklin Miller and Robert Truog about withdrawal of life-sustaining treatment and causation. The authors argue that traditional medical ethics, and the law, are mistaken to take the view that withdrawal merely allows the patient to die, rather than causing the patient's death, describing such a view as 'patently false'. They argue that the law's continued position to the contrary stems from a moral bias, resulting in the moral and legal fiction that withdrawal does not cause death but lets the patient die. In so arguing, Miller and Truog join a long line of academic criticism of the law that extends back to the seminal decision of Airedale NHS Trust v Bland [1993] AC 789 (HL) and beyond. In this article, I take issue with these claims. I argue that there are reasonable grounds upon which traditional medical ethics and the law can regard withdrawal of life-sustaining treatment as allowing the patient to die rather than causing death, and so the authors' claims that such a view is patently false cannot be sustained. I then tease out the implications of my conclusions for the authors' claim that there is not such a great distinction between withdrawal of life-sustaining treatment, euthanasia, and assisted dying. I conclude by discussing some possible objections to my own view.

  19. Existential Concerns About Death: A Qualitative Study of Dying Patients in a Danish Hospice

    DEFF Research Database (Denmark)

    Moestrup, Lene; Hansen, Helle Ploug

    2015-01-01

    afterlife and made accurate decisions for practical aspects of their death. The patients wished to focus on positive aspects in their daily life at hospice. It hereby seems important to have ongoing reflections and to include different theoretical perspectives when providing existential support to dying...

  20. Digital radiography of the chest in pediatric patients; Die digitale Thoraxradiographie beim paediatrischen Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Puig, S. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

    2003-12-01

    The hopes placed in digital radiography have been fulfilled only partly in pediatric radiology. Specifically, the option of gaining reduced radiation exposure in combination with a similar or even improved image quality was hard to realize. The only portable digital system available for a long time were storage phosphors which were disadvantaged by an extremely limited dose-quantum-efficiency (DQE) in comparison to digital flat panel detectors. New developments and the introduction of the dual-reading system led to image qualities comparable to film-screen-systems with high resolution and achievable without dose increase, sometimes even with dose reduction. A study using an animal model suggests that these systems can even be used in preterm infants with very low birth weights. A new portable flat panel detector by Canon may improve digital chest radiography in pediatric patients. (orig.) [German] Erwartungen, die man anfaenglich in die digitale Projektionsradiographie gesetzt hat, haben sich in der Kinderradiologie erst verzoegert oder teilweise gar nicht erfuellt. Insbesondere Hoffnungen, dass man die Strahlenbelastung bei gleich bleibender oder gar verbesserter Bildqualitaet reduzieren koennte, wurden bald enttaeuscht. Das einzige portable digitale System waren lange Zeit Phosphorplatten, die aber im Vergleich zu den Festplattendetektoren eine aeusserst limitierte Dosisquanteneffizienz (DQE) hatten. Durch neue Entwicklungen und v. a. durch die Einfuehrung des Dual-reading-Systems kann eine Bildqualitaet erreicht werden, die an hochaufloesende Film-Folien-Systeme heranreicht, ohne die Dosis erhoehen zu muessen. Teilweise ist nun auch eine Dosisreduktion moeglich. In einem Tiermodell konnte gezeigt werden, dass diese Systeme auch bei Fruehgeborenen mit einem sehr niedrigen Geburtgewicht einsetzbar sind. Hoffnung wird in ein neues portables Festplattendetektorsystem gesetzt, welches in der paediatrischen digitalen Thoraxradiographie evtl. neue Massstaebe setzen

  1. Aspects of caring for dying patients which cause anxiety to first year student nurses.

    Science.gov (United States)

    Cooper, Jan; Barnett, Mandy

    2005-08-01

    To examine what aspects of caring for dying patients cause anxiety in student nurses during their first year of training. Qualitative descriptive study. A university in the UK delivering preregistration nurse education. A purposive sample of 38 student nurses who had just completed their first year of their programme consented to participate in the study. Data triangulation was employed, with data collected from students' reflective diaries and two focus group meetings. Eight themes emerged relating to students' anxiety about caring for dying patients: coping with the physical suffering of patients: what to do or say; the severing of the relationship with the patient; the type of death; cardiopulmonary resuscitation; last offices; coping mechanisms; and interventions that would improve the student experience. Findings from the study suggest that it is aspects of the caring role, rather than personal fear of death, that form the source of much of students' anxiety.

  2. To be involved - A qualitative study of nurses' experiences of caring for dying patients.

    Science.gov (United States)

    Andersson, Erika; Salickiene, Zivile; Rosengren, Kristina

    2016-03-01

    The aim of this study was to describe nurses' experiences (>two years) of caring for dying patients in surgical wards. Palliative care is included in education for nurses. However, the training content varies, and nurse educators need to be committed to the curriculum regarding end-of-life situations. A lack of preparation among newly graduated nurses regarding dying and death could lead to anxiety, stress and burnout. Therefore, it is important to improve knowledge regarding end-of-life situations. A qualitative descriptive study was carried out in two surgical wards in the southern part of Sweden. The study comprised six interviews with registered nurses and was analysed using manifest qualitative content analysis, a qualitative method that involves an inductive approach, to increase our understanding of nurses' perspectives and thoughts regarding dying patients. The results formed one category (caring-to be involved) and three subcategories (being supportive, being frustrated and being sensitive in the caring processes). Nurses were personally affected and felt unprepared to face dying patients due to a lack of knowledge about the field of palliative care. Their experiences could be described as processes of transition from theory to practice by trial and error. Supervision is a valuable tool for bridging the gap between theory and practice in nursing during the transition from novice to expert. Improved knowledge about palliative care during nursing education and committed nursing leadership at the ward level facilitate preparation for end-of-life situations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. The impact on patient trust of legalising physician aid in dying

    Science.gov (United States)

    Hall, M; Trachtenberg, F; Dugan, E

    2005-01-01

    Objective: Little empirical evidence exists to support either side of the ongoing debate over whether legalising physician aid in dying would undermine patient trust. Design: A random national sample of 1117 US adults were asked about their level of agreement with a statement that they would trust their doctor less if "euthanasia were legal [and] doctors were allowed to help patients die". Results: There was disagreement by 58% of the participants, and agreement by only 20% that legalising euthanasia would cause them to trust their personal physician less. The remainder were neutral. These attitudes were the same in men and women, but older people and black people had more agreement that euthanasia would lower trust. However, overall, only 27% of elderly people (age 65+) and 32% of black people thought that physician aid in dying would lower trust. These views differed with physical and mental health, and also with education and income, with those having more of these attributes tending to view physician aid in dying somewhat more favourably. Again, however, overall views in most of these subgroups were positive. Views about the effect of physician aid in dying on trust were significantly correlated with participants' underlying trust in their physicians and their satisfaction with care. In a multivariate regression model, trust, satisfaction, age, and white/black race remained independently significant. Conclusion: Despite the widespread concern that legalising physician aid in dying would seriously threaten or undermine trust in physicians, the weight of the evidence in the USA is to the contrary, although views vary significantly. PMID:16319229

  4. [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.

  5. Beyond simple planning: existential dimensions of conversations with patients at risk of dying from heart failure.

    Science.gov (United States)

    Schulz, Valerie; Crombeen, Allison; Marshall, Denise; Shadd, Joshua; LaDonna, Kori; Lingard, Lorelei

    2017-08-04

    Despite the recent promotion of communication guides to improve decision-making with patients nearing the end of their lives, these conversations remain challenging. Deeper and more comprehensive understanding of communication barriers that undermine discussions and decisions with patients at risk of dying from heart failure (HF) are vital for informing communication in healthcare. To explore experiences and perspectives of patients with advanced HF, their caregivers and providers, regarding conversations for patients at risk of dying from HF. Following Research Ethics Board approval, index patients with advanced HF (NYHA III or IV) and consenting patient-identified care team members were interviewed. A Team Sampling Unit (TSU) was formed when the patient plus at least two additional "team members" participated in interviews.(16) Team members included health professionals (e.g., cardiologist, family physician, HF nurse practitioner, social worker, and specialists such as respirologist, nephrologist, palliative care physician), family caregivers (e.g., daughter, spouse, roommate, close friend) and community members (e.g., minister, neighbor, regular taxi driver). Our dataset included 209 individual interviews clustered into 50 TSUs at five sites from three Canadian provinces. Key informants, identified as practicing experts in the field, reviewed our initial findings with attention to relevance to practice as a form of triangulation. Iterative data collection and analysis followed constructivist grounded theory procedures with sensitizing concepts drawn from complexity theory. To ensure confidentiality, all participants were given a pseudonym. Participants' reports of their perceptions and experiences of conversations related to death and dying suggested two main dimensions of such conversations: instrumental and existential. Instrumental dimensions included how these conversations were planned and operationalized, and the triggers and barriers to these discussions

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Epidemiological and clinical characteristics of patients who died from Influenza A(H1N1pdm09 in Viet Nam

    Directory of Open Access Journals (Sweden)

    Phan Thanh Tinh

    2012-02-01

    Full Text Available We describe the epidemiological and clinical characteristics of patients who died from influenza A(H1N1pdm09 in hospitals in Viet Nam between August 2009 and March 2010.Of 58 fatal cases, 32 (55% were below 30 years of age and 14 (24% were pregnant females. Forty-five (78% patients had at least one underlying medical condition including chronic heart, kidney or lung diseases or pregnancy. Twelve (21% cases sought medical attention on the day of symptom onset. Only 13 (36% of 36 cases for whom treatment data were available had been given antiviral drugs within the recommended two days of symptom onset.The clinical and epidemiologic characteristics of the patients who died from influenza A(H1N1pdm09 are similar to those reported from other countries. To improve preparedness and response to future pandemics, Viet Nam needs to strengthen the surveillance of influenza; increase laboratory capacity to test for influenza viruses; and develop strategies for promoting the timely attendance of at-risk individuals at health facilities and the early administration of antiviral drugs, particularly for persons with underlying medical conditions and pregnant females.

  8. MEFV Gene Profile in Northwest of Iran, Twelve Common MEFV Gene Mutations Analysis in 216 Patients with Familial Mediterranean Fever

    Directory of Open Access Journals (Sweden)

    Farhad Salehzadeh

    2015-01-01

    Full Text Available Familial Mediterranean Fever (FMF is a hereditary autoinflammatory disease with autosomal recessive inheritance pattern often seen around the Mediterranean Sea. It is characterized by recurrent episodes of fever and polyserositis and rash. Recently, MEFV gene analysis determines the definitive diagnosis of FMF. In this study, we analyzed 12 MEFV gene mutations in more than 200 FMF patients, previously diagnosed by Tel-Hashomer clinical criteria, in northwest of Iran, located in the proximity of the Mediterranean Sea. In the northwest of Iran (Ardabil, 216 patients with FMF diagnosis, based on Tel-Hashomer criteria, referred to the genetic laboratory to be tested for the following mutations; P369S, F479L, M680I(G/C, M680I(G/A, I692del, M694V, M694I, K695R, V726A, A744S, R761H, E148Q. All patients were screened for MEFV gene mutations by a reverse hybridization assay (FMF Strip Assay, Vienna lab, Vienna, Austria according to manufacturer’s instructions. Among these FMF patients, no mutation was detected in 51 (23/62% patients, but 165 (76/38% patients had one or two mutations, 33 patients (15/28% homozygous, 86 patients (39/81% compound heterozygous and 46 patients (21/29% were heterozygous. The most common mutations were M694V (23/61%, V726A (11/11% and E148Q (9/95% respectively. MEFV gene mutations showed similarities and dissimilarities in different ethnic groups, while it is common among Arabs and Armenians genotype. Since common 12 MEFV gene analysis could not detect up to 50% of our patients, who had FMF on the basis of clinical Tel-Hashomer criteria, clinical criteria is still the best way in the diagnosis of FMF in this area.

  9. Liver histology in ICU patients dying from sepsis:A clinico-pathological study

    Institute of Scientific and Technical Information of China (English)

    John Koskinas; Ilias P Gomatos; Dina G Tiniakos; Nikolaos Memos; Maria Boutsikou; Aspasia Garatzioti; Athanasios Archimandritis; Alexander Betrosian

    2008-01-01

    AIM:To determine end-stage pathologic changes in the liver of septic patients dying in the intensive care unit.METHODS:Needle liver biopsies obtained immediately after death from 15 consecutive patients with sepsis and no underlying liver disease were subjected to routine histological examination.Liver function tests and clinical monitoring measurements were also recorded.RESULTS:Liver biochemistries were increased in the majority of patients before death.Histology of liver bi-opsy specimens showed portal inflammation in 73.3%,centrilobular necrosis in 80%,lobular inflammation in 66.7%,hepatocellular apoptosis in 66.6% and cholan-gitis/cholangiolitis in 20% of patients.Mixed hepatitic/cholestatic type of liver injury was observed in 6/15 (40%)patients and hepatitc in 9/15 (60%).Steatosis was ob-served in 11/15 (73.3%) patients affecting 5%-80% of liver parenchyma.Among the histological features,the presence of portal inflammation in liver biopsy was as-sociated with increased hospitalization in the ICU prior death (P = 0.026).CONCLUSION:Features of hepatitis and steatosis are the main histological findings in the liver in the majority of patients dying from sepsis.

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

    Science.gov (United States)

    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.

  11. 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.

  12. [Periodic fever: a description of twelve patients with periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA)].

    Science.gov (United States)

    De Cunto, Carmen; Britos, María; Eymann, Alfredo; Deltetto, Noelia; Liberatore, Diana

    2010-10-01

    PFAPA is a periodic fever syndrome characterized by: fever, aphthous stomatitis, pharyngitis and cervical adenitis. It is one of the autoinflammatory syndromes, but yet of unknown etiology. Our aim is to report our experience, describe clinical manifestations, laboratory findings, relapses occurrence and response to treatment. We present 12 PFAPA patients. Median age at onset: 1.15 years, mean duration of febrile episodes: 4 days, and relapses at regular intervals. All children received prednisone (1-2 mg/kg/dose) one to two doses, 9 patients responded immediately after the first dose and all experienced a lower periodicity of attacks. PFAPA is the most frequent periodic fever syndrome. To our knowledge, there are no other local series of PFAPA patients published. Recognizing this syndrome will prevent from ordering unnecessary studies and will favor family coping.

  13. Twelve-year results of a direct-bonded partial prosthesis in a patient with advanced periodontitis: a clinical report.

    Science.gov (United States)

    Minami, Hiroyuki; Minesaki, Yoshito; Suzuki, Shiro; Tanaka, Takuo

    2012-08-01

    Prosthodontic treatment for patients with advanced periodontitis is a therapeutic challenge. A minimally invasive technique is preferred to preserve the remaining mobile abutment teeth. This report describes the initial clinical treatment and 12-year follow-up of a direct-bonded prosthesis reinforced with a cast metal framework, used as a conservative treatment option to replace periodontally involved maxillary lateral incisors.

  14. Improving Physical Health in Patients With Chronic Mental Disorders: Twelve-Month Results From a Randomized Controlled Collaborative Care Trial.

    Science.gov (United States)

    Kilbourne, Amy M; Barbaresso, Michelle M; Lai, Zongshan; Nord, Kristina M; Bramlet, Margretta; Goodrich, David E; Post, Edward P; Almirall, Daniel; Bauer, Mark S

    2017-01-01

    Persons with chronic mental disorders are disproportionately burdened with physical health conditions. We determined whether Life Goals Collaborative Care compared to usual care improves physical health in patients with mental disorders within 12 months. This single-blind randomized controlled effectiveness study of a collaborative care model was conducted at a midwestern Veterans Affairs urban outpatient mental health clinic. Patients (N = 293 out of 474 eligible approached) with an ICD-9-CM diagnosis of schizophrenia, bipolar disorder, or major depressive disorder and at least 1 cardiovascular disease risk factor provided informed consent and were randomized (February 24, 2010, to April 29, 2015) to Life Goals (n = 146) or usual care (n = 147). A total of 287 completed baseline assessments, and 245 completed 12-month follow-up assessments. Life Goals included 5 weekly sessions that provided semistructured guidance on managing physical and mental health symptoms through healthy behavior changes, augmented by ongoing care coordination. The primary outcome was change in physical health-related quality of life score (Veterans RAND 12-item Short Form Health Survey [VR-12] physical health component score). Secondary outcomes included control of cardiovascular risk factors from baseline to 12 months (blood pressure, lipids, weight), mental health-related quality of life, and mental health symptoms. Among patients completing baseline and 12-month outcomes assessments (N = 245), the mean age was 55.3 years (SD = 10.8; range, 25-78 years), and 15.4% were female. Intent-to-treat analysis revealed that compared to those in usual care, patients randomized to Life Goals had slightly increased VR-12 physical health scores (coefficient = 3.21; P = .01). Patients with chronic mental disorders and cardiovascular disease risk who received Life Goals had improved physical health-related quality of life. ClinicalTrials.gov identifiers: NCT01487668 and NCT01244854.

  15. Twelve-year experience of radioembolization for colorectal hepatic metastases in 214 patients: survival by era and chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Lewandowski, Robert J.; Memon, Khairuddin; Hickey, Ryan; Gates, Vanessa L.; Atassi, Bassel; Vouche, Michael; Atassi, Rohi; Desai, Kush; Hohlastos, Elias; Sato, Kent; Habib, Ali [Robert H. Lurie Comprehensive Cancer Center, Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, IL (United States); Mulcahy, Mary F.; Kircher, Sheetal; Newman, Steven B.; Nimeiri, Halla; Benson, Al B. [Northwestern University, Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL (United States); Marshall, Karen; Williams, Melissa; Salzig, Krystina; Salem, Riad [Robert H. Lurie Comprehensive Cancer Center, Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, IL (United States); Northwestern University, Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL (United States)

    2014-10-15

    The aim of this study was to analyze the safety, treatment characteristics and survival outcomes of Yttrium-90 (Y90) radioembolization for unresectable colorectal carcinoma (CRC) liver metastases refractory to standard of care therapy. A total of 214 patients with CRC metastases were treated with Y90 radioembolization over 12 years. Toxicity was assessed using National Cancer Institute common terminology criteria. Overall survival was analyzed from date of diagnosis of primary cancer, hepatic metastases and from the first Y90. Uni/multivariate analyses were performed. Substratification by era of chemotherapeutics was performed. Most patients were male (60 %) and <65 years old (61 %). Of them, 98 % had been exposed to chemotherapy. Grade 3 lymphocyte, bilirubin, albumin, ALP and AST toxicities were observed in 39 %, 11 %, 10 %, 8 % and 4 % of patients, respectively. Grade 4 lymphocyte and ALP toxicities were observed in 5 % and 3 % of patients, respectively. Median overall survival was 43.0, 34.6, and 10.6 months from date of diagnosis of primary cancer, hepatic metastases and first Y90, respectively. Survival was significantly longer in patients: (1) who received ≤2 cytotoxic drugs (n = 104) than those who received 3 (n = 110) (15.2 vs. 7.5 months, p = 0.0001); and (2) who received no biologic agents (n = 52) compared with those that did (n = 162) (18.6 vs. 9.4 months, p = 0.0001). Multivariate analyses identified ≤2 cytotoxic agents, no exposure to biologics, ECOG 0, tumor burden <25 %, lack of extrahepatic disease and albumin >3 g/dL as independent predictors of survival. In this largest metastatic CRC series published to date, Y90 radioembolization was found to be safe; survival varied by prior therapy. Further studies are required to further refine the role of Y90 in metastatic CRC. (orig.)

  16. Minorities, men, and unmarried amyotrophic lateral sclerosis patients are more likely to die in an acute care facility.

    Science.gov (United States)

    Goutman, Stephen A; Nowacek, Dustin G; Burke, James F; Kerber, Kevin A; Skolarus, Lesli E; Callaghan, Brian C

    2014-09-01

    Studies suggest that dying at home is a more favorable experience. This study investigated where amyotrophic lateral sclerosis (ALS) patients die and the patient demographics associated with dying in an acute care facility or nursing home compared to home or hospice. Centers for Disease Control and Prevention Multiple Cause Mortality Files from 2005 to 2010 were used to identify ALS patients and to classify place of death. Multinomial logistic regression was used to determine the association between patient demographics and place of death. Between 2005 and 2010, 40,911 patients died of ALS in the United States. Place of death was as follows: home or hospice facility 20,231 (50%), acute care facility (25%), and nursing home (20%). African Americans (adjusted multinomial odds ratio (aMOR) 2.56, CI 2.32-2.83), Hispanics (aMOR 1.44, CI 1.30-1.62), and Asians (aMOR 1.87, CI 1.57-2.22) were more likely to die in an acute care facility, whereas females (aMOR 0.76, CI 0.72-0.80) and married individuals were less likely. Hispanics (aMOR 0.68, CI 0.58-0.79) and married individuals were less likely to die in a nursing home. In conclusion, minorities, men, and unmarried individuals are more likely to die in an acute care facility. Further studies are needed to better understand place of death preferences.

  17. Metabolic status of 1088 patients after renal transplantation: Assessment of twelve years monitoring in Algiers Mustapha Hospital

    Directory of Open Access Journals (Sweden)

    Lyece Yargui

    2014-01-01

    Full Text Available Since the introduction of monitoring levels of immunosuppressive medications in our service in July 2000, 1088 kidney transplant patients were received for therapeutic drug monitoring and regular follow-up. The aim of this study was to retrospectively analyze the data on these renal graft patients in Algeria and correlate with our 12 years′ experience with calcineurin inhibitor (CNI measurements. In addition, during this period, we also examined other bioche-mical parameters. The analysis was focused on the difference of effect of cyclosporin A (CsA; 623 patients and Tacrolimus (Tac; 465 patients on lipid and glucose metabolism and their side-effects, if any, on the renal function. The mean age at the time of transplantation was 36.1 years. A great majority of the transplanted kidneys had been taken from living related donors (88.6%. Three-quarters of all grafts were transplanted in our country (79.5%. Dyslipidemia and renal dysfunction were the most common adverse effects of CsA and Tac exposure, with a frequency of 21.4% and 10.3%, respectively. Both the CNIs had a similar effect on the lipid levels. The highest incidence occurred at 3-12 months after renal graft. Tac seemed to have more side-effects on glycemia, causing the onset of diabetes mellitus more than two-fold than CsA (6.9% vs. 3.1%. A significant difference was observed during 12-24 months after transplantation. However, Tac was associated with the most favorable effects on renal function estimated with the Modification of Diet in Renal Disease (MDRD formula.

  18. Annual economic burden of hepatitis B virus-related diseases among hospitalized patients in twelve cities in China.

    Science.gov (United States)

    Zhang, S; Ma, Q; Liang, S; Xiao, H; Zhuang, G; Zou, Y; Tan, H; Liu, J; Zhang, Y; Zhang, L; Feng, X; Xue, L; Hu, D; Cui, F; Liang, X

    2016-03-01

    A nationwide survey of hepatitis B virus (HBV)-associated economic burden has not previously been performed in China. The purpose of this study was to examine the direct, indirect, and intangible costs of HBV-related diseases within the span of one year. A random sample was taken from specialty and general hospitals across 12 cities in six provinces of China. Intangible costs were estimated based on willingness to pay or open-ended answers provided by patients. The results showed that 27 hospitals were enrolled, with a sample population of 4726 patients (77.7% response rate). The average annual costs were $4454.0 (direct), $924.3 (indirect), and $6611.10 (intangible), corresponding to 37.3%, 7.7%, and 55.1% of the total costs, respectively. The direct medical fees were substantially greater than the non-medical fees. Annual indirect costs were divided into outpatient ($112.9) and inpatient ($811.40) loss of income. The intangible costs of chronic HBV were notably higher than either the direct or indirect costs, consistent with the social stigma in China. The comparison amongst individual cities for the average ratio of direct to indirect costs revealed that the sizes of ratios were negatively correlated with the socioeconomic status of the regions. This study suggested that as a whole in China, the HBV-related diseases caused a heavy financial burden which was positively associated with disease severity. Although the intangible costs coincided with a high prevalence of discrimination against CHB patients in Chinese society, our study may serve as future reference for detailed exploration.

  19. Twelve-month outcomes in patients with retinal vein occlusion treated with low-frequency intravitreal ranibizumab

    Directory of Open Access Journals (Sweden)

    Sakanishi Y

    2016-06-01

    Full Text Available Yoshihito Sakanishi, Ami Lee, Ayumi Usui-Ouchi, Rei Ito, Nobuyuki Ebihara Department of Ophthalmology, Juntendo University Urayasu Hospital, Urayasu City, Chiba, Japan Purpose: The purpose of this study was to determine the clinical efficacy of low-frequency intravitreal ranibizumab to treat macular edema due to retinal vein occlusion (RVO.Patients and methods: This was a retrospective examination of cases that received intravitreal ranibizumab for untreated RVO over a period of 12 months. Instead of the conventional three monthly injections, injections were given once during the introductory period. If the recurrence of macular edema was diagnosed during the monthly visit, additional injections were given as needed. There were 21 eyes of 21 patients with branch RVO (BRVO and ten eyes of ten patients with central RVO (CRVO. The parameters examined included the number of injections over the 12-month period, improvements in best-corrected visual acuity (BCVA, and the central macular thickness (CMT. For BRVO, preinjection parameters that had an effect on the prognosis of BCVA after the 12-month period were also examined.Results: The total mean number of injections over the 12-month period was 3.4 for CRVO and 2.1 for BRVO. For CRVO, the BCVA in log minimum angular resolution changed from a preinjection value of 0.80 to 0.55 at 12 months. For BRVO, the change was from 0.51 to 0.30. For all diseases, BCVA improved after 12 months compared with the preinjection values (P<0.05. There was improvement in the CMT, and the CRVO changed from 765.0 µm at preinjection to 253.5 µm 12 months later. BRVO changed from 524.1 to 250.1 µm, and preinjection BCVA was associated with a prognosis of visual acuity after 12 months of the initial injection (P=0.0485.Conclusion: Even with a low number of injections during the introductory period, there were still improvements in both visual acuity and CMT in RVO patients after 12 months, indicating that it was

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

    Science.gov (United States)

    Lin, Yanxia; Myall, Michelle; Jarrett, Nikki

    2017-06-21

    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.

  1. Marie Curie nurses: enabling patients with cancer to die at home.

    Science.gov (United States)

    Higginson, Irene J; Wilkinson, Susie

    2002-05-01

    Marie Curie Cancer Care established its nursing service in 1958; however, the service has had little formal evaluation. This study aimed to describe and evaluate the care provided by Marie Curie nurse, and in particular to determine whether patients in their care remained and died at home. Two existing data sets were used: data on all patients referred to the Marie Curie Nursing Services in 147 areas of England, Wales, Scotland and Northern Ireland for 26 months, and data on cancer death registrations in England. A request for a Marie Curie nurse was made for 26,632 patients, 97% of whom had cancer and 11% of whom lived alone. The amount of care provided varied enormously (Marie Curie nurses facilitated home death for many patients. Services need to ensure that mechanisms are in place to achieve data collection. Rigorous prospective evaluation is needed in the future.

  2. Nutrition and hydration in dying patients: the perceptions of acute care nurses.

    Science.gov (United States)

    Higgins, Isabel; van der Riet, Pamela; Sneesby, Ludmilla; Good, Phillip

    2014-09-01

    To explore the perceptions of nurses regarding the provision and nonprovision of medical nutrition and hydration during the end stage of life when death is imminent in the acute care setting. When people are dying, they often experience a loss of appetite and desire for drinking which are natural processes at this time. The cessation of eating and drinking challenges both family members and clinical staff. This article builds on previous studies that describe the perceptions of medical doctors and palliative care nurses regarding medical nutrition and hydration during the end stage of life when death is imminent. Qualitative descriptive design. This study included three focus group meetings with ten nurses in an acute care setting in medical, oncology and haematology units. An interview schedule was used to guide the discussions. The main theme to emerge from this study was 'finding a comfort space/ambiguous spaces of unrest' that included four subthemes: (1) limited involvement in decision-making, (2) comfort vs. discomfort, (3) uncertainty and (4) the comfort of withdrawing treatment. Finding a comfort space captures the challenges nurses faced when speaking about the concerns of patients and family. In this space, there were ambiguities that created unease and unrest: a reluctance to talk about death; a reluctance to engage with the patient and the family. Acute care nurses need to be more cognisant of the palliative approach to care and become more engaged with decision-making during the end stage of life when death is imminent. Nurses in acute care settings need to be involved in decision-making and advocate for patients and family during the dying phase. Nurses in acute care need better understanding about the palliative approach to care and nutrition and hydration for people who are dying. © 2013 John Wiley & Sons Ltd.

  3. Die binding van die konfessie

    Directory of Open Access Journals (Sweden)

    P. J. Coetzee

    1970-06-01

    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.

  4. Die instelling van die doop

    Directory of Open Access Journals (Sweden)

    J. L. Venter

    1989-06-01

    Full Text Available Die eerste plek in die evangeliebeskrywings waar daar van die doop as ’n opdrag van Jesus Christus gepraat word en waar die betekenis die duidelikste uitkristalliseer, staan in Matteus 28 : 16 - 20. Heilshistories gesien, is dit die begin van kerklike inlywing van die wat gehoor het hoedat Jesus sy koninkryk proklameer, die evangelie aanvaar en tot bekering kom. Vir die doel van hierdie artikel word hierdie gedeelte ondersoek om te sien hoe die instelling geskied het, wat die plek en betekenis van die Christelike doop is.

  5. Use of Pentamidine As Secondary Prophylaxis to Prevent Visceral Leishmaniasis Relapse in HIV Infected Patients, the First Twelve Months of a Prospective Cohort Study.

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    Ermias Diro

    Full Text Available Visceral leishmaniasis (VL has become an important opportunistic infection in persons with HIV-infection in VL-endemic areas. The co-infection leads to profound immunosuppression and high rate of annual VL recurrence. This study assessed the effectiveness, safety and feasibility of monthly pentamidine infusions to prevent recurrence of VL in HIV co-infected patients.A single-arm, open-label trial was conducted at two leishmaniasis treatment centers in northwest Ethiopia. HIV-infected patients with a VL episode were included after parasitological cure. Monthly infusions of 4 mg/kg pentamidine-isethionate diluted in normal-saline were started for 12 months. All received antiretroviral therapy (ART. Time-to-relapse or death was the primary end point.Seventy-four patients were included. The probability of relapse-free survival at 6 months and at 12 months was 79% and 71% respectively. Renal failure, a possible drug-related serious adverse event, occurred in two patients with severe pneumonia. Forty-one patients completed the regimen taking at least 11 of the 12 doses. Main reasons to discontinue were: 15 relapsed, five died and seven became lost to follow-up. More patients failed among those with a CD4+cell count ≤ 50 cells/μl, 5/7 (71.4% than those with counts above 200 cells/μl, 2/12 (16.7%, (p = 0.005.Pentamidine secondary prophylaxis led to a 29% failure rate within one year, much lower than reported in historical controls (50%-100%. Patients with low CD4+cell counts are at increased risk of relapse despite effective initial VL treatment, ART and secondary prophylaxis. VL should be detected and treated early enough in patients with HIV infection before profound immune deficiency installs.

  6. Dying well: How equal is end of life care among gynecologic oncology patients?

    Science.gov (United States)

    Taylor, Jolyn S; Brown, Alaina J; Prescott, Lauren S; Sun, Charlotte C; Ramondetta, Lois M; Bodurka, Diane C

    2016-02-01

    To identify disparities in utilization of end of life (EoL) resources by gynecologic oncology (GO) patients. This retrospective analysis of the medical records of GO patients treated 1/2007-12/2011 and deceased 1/2012-8/2014 evaluated patient demographics, disease characteristics, and utilization of EoL resources. Chi-square, Fisher's exact test, Mann Whitney and Kruskal-Wallis tests were used for statistical analysis. Of 189 patients analyzed, 113 (60%) were white, 38 (20%) Hispanic, 31 (16%) black, and seven (4%) Asian. Ninety-five (48%) had ovarian cancer, 51 (26%) uterine, 47 (23%) cervical, seven (3%) vulvar/vaginal. In the last 30days of life (DoL), 18 (10%) had multiple hospital admissions, 10 (5%) admitted to the Intensive Care Unit (ICU), 30 (16%) multiple Emergency Room (ER) visits, 45 (24%) received aggressive medical care and eight (4%) received chemotherapy in the final 14 DoL. Furthermore, 54 (29%) had no Supportive Care referral and 29 (15%) no hospice referral. Only 46 (24%) had a Medical Power of Attorney (PoA) or Living Will (LW) on file. Non-white race was associated with increased odds of dying without hospice (OR 3.07; 95%CI [1.27, 2.46], p=0.013). However, non-white patients who enrolled in hospice did so earlier than white patients (42 v. 27days before death, p=0.054). Non-white patients were also significantly less likely to have PoA/LW documentation (24% v. 76%, p=0.009) even if enrolled in hospice (12% v. 31%, p=0.007). Significant racial disparities in hospice enrollment and PoA/LW documentation were seen in GO patients. This warrants further study to identify barriers to use of EoL resources. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. How can nurses support relatives of a dying patient with the organ donation option?

    Science.gov (United States)

    Mills, Leanne; Koulouglioti, Christina

    2016-07-01

    The UK Department of Health in 2008 established the Organ Donation Taskforce to improve organ donation within the UK. Knowing how nurses can best support families during this time is important to maintain best practice. The purpose of the literature review was to summarise evidence related to nursing support for a dying patient's family with the option of organ donation. The (a) Allied Medical Education Database (AMED), (b) British Nursing Index (BNI), (c) Cochrane Library, (d) Cumulative Index to Nursing and Allied Health Literature (CINAHL), (e) NHS Evidence, and (f) PubMed were searched during January to May 2013 using the key words: organ donation, nurse, support, organ donor, family. A total of 23 articles were critiqued to synthesise available evidence over 25 years. Primary sources addressing deceased organ donors, their families and nurses, written in English, in peer reviewed journals over the last 25 years and conducted internationally were included. Articles related to consent, attitudes towards donation and physicians' views were excluded. Two major themes emerged: (a) clarity of communication and understanding of information and (b) the nurse's competency. This study adds to the topic by addressing support needed by a family. Correct information given to a family clearly, sensitively and in a professional manner can accommodate relatives' understanding why their loved one is in a critical condition, which can help them accept death and therefore consider the option of organ donation. Nurses must acquire through regular training specific skills and knowledge in order to practice efficiently and adhere to the needs of a dying patient's family. By incorporating organ donation as a norm in end-of-life care, bereavement needs can be addressed in addition to improving organ donation rates. © 2015 British Association of Critical Care Nurses.

  8. The attitudes of brain cancer patients and their caregivers towards death and dying: a qualitative study

    Directory of Open Access Journals (Sweden)

    Kimmelman Jonathan

    2007-11-01

    Full Text Available Abstract Background Much money and energy has been spent on the study of the molecular biology of malignant brain tumours. However, little attention has been paid to the wishes of patients afflicted with these incurable tumours, and how this might influence treatment considerations. Methods We interviewed 29 individuals – 7 patients dying of a malignant brain tumor and 22 loved ones. One-on-one interviews were conducted according to a pre-designed interview guide. A combination of open-ended questions, as well as clinical scenarios was presented to participants in order to understand what is meaningful and valuable to them when determining treatment options and management approaches. The results were analyzed, coded, and interpreted using qualitative analytic techniques in order to arrive at several common overarching themes. Results Seven major themes were identified. In general, respondents were united in viewing brain cancer as unique amongst malignancies, due in large part to the premium placed on mental competence and cognitive functioning. Importantly, participants found their experiences, however difficult, led to the discovery of inner strength and resilience. Responses were usually framed within an interpersonal context, and participants were generally grateful for the opportunity to speak about their experiences. Attitudes towards religion, spirituality, and euthanasia were also probed. Conclusion Several important themes underlie the experiences of brain cancer patients and their caregivers. It is important to consider these when managing these patients and to respect not only their autonomy but also the complex interpersonal toll that a malignant diagnosis can have.

  9. The attitudes of brain cancer patients and their caregivers towards death and dying: a qualitative study

    Science.gov (United States)

    Lipsman, Nir; Skanda, Abby; Kimmelman, Jonathan; Bernstein, Mark

    2007-01-01

    Background Much money and energy has been spent on the study of the molecular biology of malignant brain tumours. However, little attention has been paid to the wishes of patients afflicted with these incurable tumours, and how this might influence treatment considerations. Methods We interviewed 29 individuals – 7 patients dying of a malignant brain tumor and 22 loved ones. One-on-one interviews were conducted according to a pre-designed interview guide. A combination of open-ended questions, as well as clinical scenarios was presented to participants in order to understand what is meaningful and valuable to them when determining treatment options and management approaches. The results were analyzed, coded, and interpreted using qualitative analytic techniques in order to arrive at several common overarching themes. Results Seven major themes were identified. In general, respondents were united in viewing brain cancer as unique amongst malignancies, due in large part to the premium placed on mental competence and cognitive functioning. Importantly, participants found their experiences, however difficult, led to the discovery of inner strength and resilience. Responses were usually framed within an interpersonal context, and participants were generally grateful for the opportunity to speak about their experiences. Attitudes towards religion, spirituality, and euthanasia were also probed. Conclusion Several important themes underlie the experiences of brain cancer patients and their caregivers. It is important to consider these when managing these patients and to respect not only their autonomy but also the complex interpersonal toll that a malignant diagnosis can have. PMID:17996072

  10. Challenges for computed tomography of overweight patients; Herausforderungen an die Computertomographie bei uebergewichtigen Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Bamberg, F.; Marcus, R.; Nikolaou, K.; Becker, C.R.; Reiser, M.F.; Johnson, T. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Petersilka, M. [Siemens AG, Computed Tomography, Forchheim, Healthcare Sector, Imaging and Therapy Division, Forchheim (Germany)

    2011-05-15

    modulation. In larger patients diagnostic image quality can only be achieved reliably with the dual source XXL mode, although at considerably increased calculated dose. However, standard conversion factors yield false high values so that the estimation of the biologically relevant equivalent dose is very difficult. (orig.) [German] Bei stark uebergewichtigen Patienten stellt die Computertomographie (CT) oft die einzige Moeglichkeit dar, um klinische Beschwerden nichtinvasiv bildgebend abzuklaeren. Ziel unserer Untersuchung war es, Gewichtsgrenzen, Dosis und Bildqualitaet mit Standard-CT-Geraeten zu analysieren und den diagnostischen Wert und die Dosis eines ''Zwei-Roehren''- (XXL-)Modus am Dual-source-CT zu ermitteln. Fuenfzehn Patienten wurden retrospektiv (189,6{+-}41,8 kg KG) identifiziert und mit dem XXL-Protokoll untersucht. Davon wurden 7 Patienten (176,4{+-}56,4 kg KG) mit dem XXL- und Standardprotokoll untersucht, sodass ein intraindividueller Vergleich erhoben werden konnte. Zusaetzlich wurden 14 Patienten mit einem Gewicht zwischen 90 und 150 (106,1{+-}18,5 kg KG) mit Standarduntersuchungen als Referenzgruppe eingeschlossen. Dosis, Rauschen und die subjektiv bewertete Bildqualitaet (Skala 1-4) wurden ermittelt. Zusaetzlich wurde ein Abdomenphantom mit 48 cm Durchmesser mit den beiden CT-Protokollen bei gleichem Roehrenstromzeitprodukt untersucht, um die Dosiseffizienz zu vergleichen. Die Patientengruppen unterschieden sich signifikant hinsichtlich der Dosis (CTDI{sub vol} XXL 72,9{+-}23 vs. Standard 16,7{+-}11 mGy; intraindividuell 64,1{+-}20 vs. 27,0{+-}15 mGy). In der XXL-Gruppe war das Rauschen insgesamt etwas hoeher, im intraindividuellen Vergleich dagegen signifikant niedriger (Leber 24,2{+-}14 vs. 36,3{+-}20 [Hounsfield Units, HU]; p=0,03; Fett 15,5{+-}8 vs. 26,2{+-}12 HU; p=0,02). Bezueglich der Bildqualitaet ergab sich mit 1,9{+-}0,7 vs. 1,8{+-}0,7 im Gesamtkollektiv kein Unterschied, wohl aber in der intraindividuellen Vergleichsgruppe

  11. Die topkwark

    Directory of Open Access Journals (Sweden)

    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.

  12. When cultures clash: physician, patient, and family wishes in truth disclosure for dying patients.

    Science.gov (United States)

    Lapine, A; Wang-Cheng, R; Goldstein, M; Nooney, A; Lamb, G; Derse, A R

    2001-01-01

    We describe two cases involving male foreign nationals (a Chinese and a Georgian) treated in a U.S. hospital. Both patients had terminal illnesses, and both cases involved clashes between families and the treating physicians, which occurred because of differing cultural beliefs about truth disclosure. Based on the specific backgrounds of these two patients, we discuss ethical and cultural considerations and make suggestions for physicians who care for ethnically diverse patients.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Why did the patient die? The relationship between ambulance accidents and death of patients: forensic medical issues.

    Science.gov (United States)

    Ersoy, Gokhan; Ersoy, Ozlem; Yuksekbas, Ozlem; Kurnaz, Gulay; Akyildiz, Elif Ulker; Ekemen, Suheyla

    2012-11-01

    This article's aim is investigating traumatic consequences of ambulance accident on patients and discussing difficulties to give a decision about the relation between death and accident at these cases. The cases were selected among the forensic medical reports concluded between 1996 and 2005 years. They were documented for age, sex, causes of urgent call, localization and extent of traumatic lesion, properties of events and board decisions. A total of 21 cases were found. 15 cases died on the day of the accident. Skin injuries at head (8 cases) and legs (6 cases) were most common traumatic lesions. Totally 6 deaths were found related with ambulance accident. Death of patient after ambulance accidents may not be associated easily to the accident. Delay due to accident or concomitant contributing medical conditions may also facilitate the death in this type of cases. Reliable medical records were needed for accurate medicolegal evaluation.

  15. Euthanasia in patients dying at home in Belgium: interview study on adherence to legal safeguards

    Science.gov (United States)

    Smets, Tinne; Bilsen, Johan; Van den Block, Lieve; Cohen, Joachim; Van Casteren, Viviane; Deliens, Luc

    2010-01-01

    Background Euthanasia became legal in Belgium in 2002. Physicians must adhere to legal due care requirements when performing euthanasia; for example, consulting a second physician and reporting each euthanasia case to the Federal Review Committee. Aim To study the adherence and non-adherence of GPs to legal due care requirements for euthanasia among patients dying at home in Belgium and to explore possible reasons for non-adherence. Design of study Large scale, retrospective study. Setting General practice in Belgium. Method A retrospective mortality study was performed in 2005–2006 using the nationwide Belgian Sentinel Network of General Practitioners. Each week GPs reported medical end-of-life decisions taken in all non-sudden deaths of patients in their practice. GP interviews were conducted for each euthanasia case occurring at home. Results Interviews were conducted for nine of the 11 identified euthanasia cases. Requirements concerning the patient's medical condition were met in all cases. Procedural requirements such as consultation of a second physician were sometimes ignored. Euthanasia cases were least often reported (n = 4) when the physician did not regard the decision as euthanasia, when only opioids were used to perform euthanasia, or when no second physician was consulted. Factors that may contribute to explaining non-adherence to the euthanasia law included: being unaware of which practices are considered to be euthanasia; insufficient knowledge of the euthanasia law; and the fact that certain procedures are deemed burdensome. Conclusion Substantive legal due care requirements for euthanasia concerning the patient's request for euthanasia and medical situation were almost always met by GPs in euthanasia cases. Procedural consultation and reporting requirements were not always met. PMID:20353662

  16. Euthanasia in patients dying at home in Belgium: interview study on adherence to legal safeguards.

    Science.gov (United States)

    Smets, Tinne; Bilsen, Johan; Van den Block, Lieve; Cohen, Joachim; Van Casteren, Viviane; Deliens, Luc

    2010-04-01

    Euthanasia became legal in Belgium in 2002. Physicians must adhere to legal due care requirements when performing euthanasia; for example, consulting a second physician and reporting each euthanasia case to the Federal Review Committee. To study the adherence and non-adherence of GPs to legal due care requirements for euthanasia among patients dying at home in Belgium and to explore possible reasons for non-adherence. Large scale, retrospective study. General practice in Belgium. A retrospective mortality study was performed in 2005-2006 using the nationwide Belgian Sentinel Network of General Practitioners. Each week GPs reported medical end-of-life decisions taken in all non-sudden deaths of patients in their practice. GP interviews were conducted for each euthanasia case occurring at home. Interviews were conducted for nine of the 11 identified euthanasia cases. Requirements concerning the patient's medical condition were met in all cases. Procedural requirements such as consultation of a second physician were sometimes ignored. Euthanasia cases were least often reported (n = 4) when the physician did not regard the decision as euthanasia, when only opioids were used to perform euthanasia, or when no second physician was consulted. Factors that may contribute to explaining non-adherence to the euthanasia law included: being unaware of which practices are considered to be euthanasia; insufficient knowledge of the euthanasia law; and the fact that certain procedures are deemed burdensome. Substantive legal due care requirements for euthanasia concerning the patient's request for euthanasia and medical situation were almost always met by GPs in euthanasia cases. Procedural consultation and reporting requirements were not always met.

  17. The Effects of a Course on Death and Grief on Nurses' Attitudes toward Dying Patients and Death.

    Science.gov (United States)

    Miles, Margaret Shandor

    1980-01-01

    Nurses who attended the program had a more positive attitude toward death and dying patients. Findings suggest that this kind of program might also be helpful to nurses who do not express a desire to attend such a program and to student nurses. (JAC)

  18. How do patients with heart failure with preserved ejection fraction die?

    Science.gov (United States)

    Chan, Michelle M Y; Lam, Carolyn S P

    2013-06-01

    Understanding how patients with heart failure with preserved ejection fraction (HFPEF) die provides insight into the natural history and pathophysiology of this complex syndrome, thereby allowing better prediction of response to therapy in designing clinical trials. This review summarizes the current state of knowledge surrounding mortality rates, modes of death, and prognostic factors in HFPEF. Despite the lack of uniform reporting, the following conclusions may be drawn from previous studies. The mortality burden of HFPEF is substantial, ranging from 10% to 30% annually, and higher in epidemiological studies than in clinical trials. Mortality rates compared with heart failure with reduced ejection fraction (HFREF) appear to be strongly influenced by the type of study, but are clearly elevated compared with age- and co-morbidity-matched controls without heart failure. The majority of deaths in HFPEF are cardiovascular deaths, comprising 51-60% of deaths in epidemiological studies and ∼70% in clinical trials. Among cardiovascular deaths, sudden death and heart failure death are the leading cardiac modes of death in HFPEF clinical trials. Compared with HFREF, the proportions of cardiovascular deaths, sudden death, and heart failure deaths are lower in HFPEF. Conversely, non-cardiovascular deaths constitute a higher proportion of deaths in HFPEF than in HFREF, particularly in epidemiological studies, where this difference may be related to fewer coronary heart deaths in HFPEF. Key mortality risk factors, including age, gender, body mass index, burden of co-morbidities, and coronary artery disease, offer some explanation for the differences in mortality rates observed across studies.

  19. Nurses versus physicians' knowledge, attitude, and performance on care for the family members of dying patients

    Directory of Open Access Journals (Sweden)

    Abdolghani Abdollahimohammad

    2016-03-01

    Full Text Available Purpose: Nurses and physicians must be competent enough to provide care for the clients. As a lack of knowledge and a poor attitude result in a low performance of delivering care, this study aimed to explore the nurses versus physicians’ knowledge, attitude, and performance on care for the family members of dying patients (FMDPs. Methods: This descriptive study was conducted at the educational hospitals in Isfahan, Iran. The samples were 110 nurses and 110 physicians. The data were collected through a convenience sampling method and using a valid and reliable questionnaire. Results: The average knowledge, attitude, and performance on care for the FMDPs were not significantly different between nurses and physicians (p>0.05. The majority of nurses (55.4% and physician (63.6% were at a moderate and a fair level of knowledge of care for the FMDPs. Most of the nurses (81% and physicians (87.3% had a positive attitude towards caring the FMDPs. Most of the nurses (70% and physicians (86.3% had a moderate and fair performance. Conclusion: Having enough knowledge and skills, and a positive attitude are necessary for caring the FMDPs. Nurses’ and physicians' competencies must be improved through continuing educational programs and holding international and national conferences with a focus on the palliative care.

  20. The Twelve Hotel, Barna : Video

    OpenAIRE

    Irish Food Channel

    2014-01-01

    Fergus O'Halloran, Managing Director of The Twelve Hotel in Barna in County Galway, talks about his philosophy in running this unique boutique hotel. Reproduced with kind permission from John & Sally McKenna. 3.35 mins

  1. Standardized evaluation of lung congestion during COPD exacerbation better identifies patients at risk of dying

    Directory of Open Access Journals (Sweden)

    Høiseth AD

    2013-12-01

    concentration 1.8, CI 1.2–2.6 (P=0.003.Conclusion: By applying a standardized approach when evaluating pulmonary congestion on chest radiographs during AECOPD, a group of patients with increased risk of dying, possibly due to heart failure, is identified.Keywords: heart failure, radiograph, NT-proBNP, mortality, X-ray, cephalization

  2. The timing of death in patients with tuberculosis who die during anti-tuberculosis treatment in Andhra Pradesh, South India

    Directory of Open Access Journals (Sweden)

    Jonnalagada Subbanna

    2011-12-01

    Full Text Available Abstract Background India has 2.0 million estimated tuberculosis (TB cases per annum with an estimated 280,000 TB-related deaths per year. Understanding when in the course of TB treatment patients die is important for determining the type of intervention to be offered and crucially when this intervention should be given. The objectives of the current study were to determine in a large cohort of TB patients in India:- i treatment outcomes including the number who died while on treatment, ii the month of death and iii characteristics associated with "early" death, occurring in the initial 8 weeks of treatment. Methods This was a retrospective study in 16 selected Designated Microscopy Centres (DMCs in Hyderabad, Krishna and Adilabad districts of Andhra Pradesh, South India. A review was performed of treatment cards and medical records of all TB patients (adults and children registered and placed on standardized anti-tuberculosis treatment from January 2005 to September 2009. Results There were 8,240 TB patients (5183 males of whom 492 (6% were known to have died during treatment. Case-fatality was higher in those previously treated (12% and lower in those with extra-pulmonary TB (2%. There was an even distribution of deaths during anti-tuberculosis treatment, with 28% of all patients dying in the first 8 weeks of treatment. Increasing age and new as compared to recurrent TB disease were significantly associated with "early death". Conclusion In this large cohort of TB patients, deaths occurred with an even frequency throughout anti-TB treatment. Reasons may relate to i the treatment of the disease itself, raising concerns about drug adherence, quality of anti-tuberculosis drugs or the presence of undetected drug resistance and ii co-morbidities, such as HIV/AIDS and diabetes mellitus, which are known to influence mortality. More research in this area from prospective and retrospective studies is needed.

  3. Transanal rectopexy - twelve case studies

    Directory of Open Access Journals (Sweden)

    Rubens Henrique Oleques Fernandes

    2012-06-01

    Full Text Available OBJECTIVES: This study analyzed the results of transanal rectopexy and showed the benefits of this surgical technique. METHOD: Twelve patients were submitted to rectopexy between 1997 and 2011. The surgical technique used was transanal rectopexy, where the mesorectum was fixed to the sacrum with nonabsorbable suture. Three patients had been submitted to previous surgery, two by the Delorme technique and one by the Thiersch technique. RESULTS: Postoperative hospital stay ranged from 1 to 4 days. One patient (8.3% had intraoperative hematoma, which was treated with local compression and antibiotics. One patient (8.3% had residual mucosal prolapse, which was resected. Prolapse recurrence was seen in one case (8.3%. Improved incontinence occurred in 75% of patients and one patient reported obstructed evacuation in the first month after surgery. No death occurred. CONCLUSION: Transanal rectopexy is a simple, low cost technique, which has shown good efficacy in rectal prolapse control.OBJETIVO: O presente estudo analisou os resultados da retopexia pela via transanal e expôs os benefícios desta técnica cirúrgica. MÉTODO: Doze pacientes com prolapso foram operados no período de 1997 a 2011. A técnica cirúrgica usada foi a retopexia transanal, onde o mesorreto foi fixado ao sacro com fio inabsorvível. Três pacientes tinham cirurgia prévia, dois pela técnica de Delorme e um pela técnica de Thiersch. RESULTADOS: A permanência hospitalar pós-operatória variou de 1- 4 dias. Uma paciente (8,3% apresentou hematoma transoperatório que foi tratado com compressão local e antibioticoterapia. Um paciente apresentou prolapso mucoso residual (8,3%, que foi ressecado. Houve recidiva da procidência em um caso (8,3%. A melhora da incontinência ocorreu em 75% dos pacientes e uma paciente apresentou bloqueio evacuatório no primeiro mês após a cirurgia. Não houve mortalidade entre os pacientes operados. CONCLUSÃO: A retopexia transanal é uma t

  4. Die menswaardigheid van die menslike embrio : die debat tot dusver

    National Research Council Canada - National Science Library

    Vorster, J.M

    2011-01-01

    ...), "Stem cell research: the ethical issues". Rakende die gebruik van menslike embrio's in stamselnavorsing, behandel hierdie artikels die potensiaal van die menslike embrio, die morele status (menswaardigheid...

  5. Histopathological Findings in Brains of Patients Who Died in the Acute Stage of Poor-grade Subarachnoid Hemorrhage

    Science.gov (United States)

    SATOMI, Junichiro; HADEISHI, Hiromu; YOSHIDA, Yasuji; SUZUKI, Akifumi; NAGAHIRO, Shinji

    2016-01-01

    Patients with poor-grade aneurysmal subarachnoid hemorrhage (SAH) are likely to die due to irreversible acute-stage primary brain damage. However, the mechanism(s) and pathology responsible for their high mortality rate remain unclear. We report our findings on the brains of individuals who died in the acute stage of SAH. An autopsy was performed on the brains of 11 SAH patients (World Federation of Neurosurgical Societies grade 5) who died within 3 days of admission and who did not receive respiratory assistance. All brains were free of intracranial hematoma and hydrocephalus; all harbored ruptured aneurysms. In all brains, multiple infarcts with perifocal edema were scattered throughout the cortex and subcortical white matter of the whole brain. Infarcts with a patchy – were more often seen than infarcts with a wedge-shaped pattern. Microscopic examination revealed multiple areas with cytotoxic edema and neuronal death indicative of acute ischemic changes. Edema and congestion were more obvious in areas where the subarachnoid clot tightly adhered to the pia mater. Pathologically, the brains of deceased patients with acute poor-grade SAH were characterized by edema and multifocal infarcts spread throughout the whole brain; they were thought to be attributable to venous ischemia. Diffuse disturbance in venous drainage attributable to an abrupt increase in the intracranial pressure and focal disturbances due to tight adhesion of the subarachnoid clot to the pia mater, may contribute strongly to irreversible brain damage in the acute stage of SAH. PMID:27357086

  6. Die posisie van die Helper in die sending

    Directory of Open Access Journals (Sweden)

    I. J. van der Walt

    1972-06-01

    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.

  7. 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.

  8. A Study of the Timing of Death in Patients with Tuberculosis Who Die During Anti-Tuberculosis Treatment

    Directory of Open Access Journals (Sweden)

    Bhavik Patel

    2016-06-01

    Full Text Available Introduction: India has 2.0 million estimated tuberculosis (TB cases per annum with an estimated 280,000 TB related deaths per year. Understanding when in the course of TB treatment patients die is important for determining the type of intervention to be offered and crucially when this intervention should be given. The objectives of the current study were to determine in a large cohort of TB patients in India: - i treatment outcomes including the number who died while on treatment, ii the month of death and iii characteristics associated with and ldquo;early and rdquo; death, occurring in the initial 8 weeks of treatment. Methodology: This was a retrospective study in C.U.Shah Medical College and Hospital in Surendranagar, Gujarat India. A review was performed of treatment cards and medical records of all TB patients (adults and children registered and placed on standardized anti-tuberculosis treatment from January 2007 to April 2012. Results: There were 376 TB patients of whom 41 (11% were known to have died during treatment. Case-fatality was higher in those previously treated (24% and lower in those with extra-pulmonary TB (1%.Most of deaths during anti-tuberculosis treatment were early, with 66% of all patients dying in the first 8 weeks of treatment. Increasing age and new as compared to recurrent TB disease were significantly associated with and ldquo;early death and rdquo;. In this large cohort of TB patients, Most of deaths occurred early after starting anti-TB treatment. Reasons may relate to i the treatment of the disease itself, raising concerns about drug adherence, quality of anti-tuberculosis drugs or the presence of undetected drug resistance and ii co-morbidities, such as HIV/ AIDS and diabetes mellitus, which are known to influence mortality. iii Late stage presentation by patients themselves. More research in this area from prospective and retrospective studies is needed. [Natl J Med Res 2016; 6(2.000: 186-190

  9. HLA compatibility assessment and management of highly sensitized patients under the new kidney allocation system (KAS): A 2016 status report from twelve HLA laboratories across the U.S.

    Science.gov (United States)

    Kamoun, M; Phelan, D; Noreen, H; Marcus, N; Klingman, L; Gebel, H M

    2017-01-01

    Twelve HLA laboratories were surveyed to assess the methods and operational issues involved to define highly sensitized patients and to assess HLA compatibility under the new kidney allocation system (KAS) in the U.S. All laboratories used single antigen bead assays both pre- and post-KAS to define both broad and allele-specific HLA antibodies. The methods and threshold used to list HLA unacceptable antigens in UNet for virtual crossmatch (vXM) and the criteria used for determining HLA compatibility varied among laboratories. Laboratories reported several limitations of the current assays including the accuracy of quantifiable antibody fluorescence values, inadequate coverage of common alleles on the bead panels, and challenges in calibrating the vXM. The new KAS has resulted in a significant surge of deceased donor organ offers requiring vXM evaluation under tight time constraints. In the post-KAS period, eight of twelve laboratories (67%) indicated that their center did not proceed to transplant based on vXM without a prospective lymphocyte crossmatch. In conclusion, HLA laboratories play a critical role in deceased donor allocation for highly sensitized patients under the new KAS. Significant opportunities exist to improve the methods used in the assessment of HLA compatibility to safely transplant highly sensitized patients.

  10. Truth-telling and the Asymmetry of the Attitude to Truth-telling to Dying Patients in Latvia

    Directory of Open Access Journals (Sweden)

    Ivars Neiders

    2013-05-01

    Full Text Available This article deals with concerns related to truth-telling in interaction between the doctor and the dying patient, exploring such issues as conflicting duties of veracity and non-maleficence, truthfulness and deception, and reasons behind physicians' decisions either to withhold or to disclose information about patients' diagnoses and prognoses. It focuses on various attitudes to truth-telling to dying patients, such as symmetry and asymmetry, both of which can be positive and negative. The empirical part of the article reports on the methods and results of the qualitative study carried out in Latvia during the summer of 2012. This study was based on the assessment of three case scenarios from the quantitative instrument designed by Dalla-Vorgia et al. in 1992. By means of semi-structured and focus-group interviews, evidence was gathered about physicians' and medical students' attitudes towards truth-telling, which allows the drawing of conclusions about the presence of asymmetry and symmetry in both cases. Additionally, an insight about the standards used for making decisions in case scenarios was gained and the origins of these standards were explored, revealing the aftermath of a gradual evolution from the ethics of the Soviet era to modern standards of medical ethics.

  11. Surgical nurses' attitudes towards caring for patients dying of cancer - a pilot study of an educational intervention on existential issues.

    Science.gov (United States)

    Udo, C; Melin-Johansson, C; Henoch, I; Axelsson, B; Danielson, E

    2014-07-01

    This is a randomised controlled pilot study using a mixed methods design. The overall aim was to test an educational intervention on existential issues and to describe surgical nurses' perceived attitudes towards caring for patients dying of cancer. Specific aims were to examine whether the educational intervention consisting of lectures and reflective discussions, affects nurses' perceived confidence in communication and to explore nurses' experiences and reflections on existential issues after participating in the intervention. Forty-two nurses from three surgical wards at one hospital were randomly assigned to an intervention or control group. Nurses in both groups completed a questionnaire at equivalent time intervals: at baseline before the educational intervention, directly after the intervention, and 3 and 6 months later. Eleven face-to-face interviews were conducted with nurses directly after the intervention and 6 months later. Significant short-term and long-term changes were reported. Main results concerned the significant long-term effects regarding nurses' increased confidence and decreased powerlessness in communication, and their increased feelings of value when caring for a dying patient. In addition, nurses described enhanced awareness and increased reflection. Results indicate that an understanding of the patient's situation, derived from enhanced awareness and increased reflection, precedes changes in attitudes towards communication. © 2014 John Wiley & Sons Ltd.

  12. Dying from cancer in developed and developing countries: lessons from two qualitative interview studies of patients and their carers.

    Science.gov (United States)

    Murray, Scott A; Grant, Elizabeth; Grant, Angus; Kendall, Marilyn

    2003-02-15

    To describe the experiences of illness and needs and use of services in two groups of patients with incurable cancer, one in a developed country and the other in a developing country. Scotland: longitudinal study with qualitative interviews. Kenya: cross sectional study with qualitative interviews. Lothian region, Scotland, and Meru District, Kenya. Scotland: 20 patients with inoperable lung cancer and their carers. Kenya: 24 patients with common advanced cancers and their main informal carers. Descriptions of experiences, needs, and available services. 67 interviews were conducted in Scotland and 46 in Kenya. The emotional pain of facing death was the prime concern of Scottish patients and their carers, while physical pain and financial worries dominated the lives of Kenyan patients and their carers. In Scotland, free health and social services (including financial assistance) were available, but sometimes underused. In Kenya, analgesia, essential equipment, suitable food, and assistance in care were often inaccessible and unaffordable, resulting in considerable unmet physical needs. Kenyan patients thought that their psychological, social, and spiritual needs were met by their families, local community, and religious groups. Some Scottish patients thought that such non-physical needs went unmet. In patients living in developed and developing countries there are differences not only in resources available for patients dying from cancer but also in their lived experience of illness. The expression of needs and how they are met in different cultural contexts can inform local assessment of needs and provide insights for initiatives in holistic cancer care.

  13. Wasting and sudden cardiac death in hemodialysis patients: a post hoc analysis of 4D (Die Deutsche Diabetes Dialyse Studie).

    Science.gov (United States)

    Drechsler, Christiane; Grootendorst, Diana C; Pilz, Stefan; Tomaschitz, Andreas; Krane, Vera; Dekker, Friedo; März, Winfried; Ritz, Eberhard; Wanner, Christoph

    2011-10-01

    Wasting is common in hemodialysis patients and often is accompanied by cardiovascular disease and inflammation. The cardiovascular risk profile meaningfully changes with the progression of kidney disease, and little is known about the impact of wasting on specific clinical outcomes. This study examined the effects of wasting on the various components of cardiovascular outcome and deaths caused by infection in hemodialysis patients. Prospective cohort study. 1,255 hemodialysis patients from 178 centers participating in Die Deutsche Diabetes Dialyse Studie (4D) in 1998-2004. Moderate wasting was defined as body mass index, albumin, and creatinine values less than the median (26.7 kg/m(2), 3.8 g/dL, and 6.8 mg/dL, respectively) and C-reactive protein level less than the median (5 mg/L) at baseline. Severe wasting was defined as body mass index, albumin, and creatinine levels less than the median and C-reactive protein level greater than the median at baseline. Risks of sudden cardiac death (SCD), myocardial infarction (MI), stroke, combined cardiovascular events, deaths due to infection, and all-cause mortality were determined using Cox regression analyses during a median of 4 years of follow-up. 196 patients had wasting (severe, n = 109; and moderate, n = 87). Overall, 617 patients died (160 of SCD and 128 of infectious deaths). Furthermore, 469 patients experienced a cardiovascular event, with MI and stroke occurring in 200 and 103 patients, respectively. Compared with patients without wasting (n = 1,059), patients with severe wasting had significantly increased risks of SCD (adjusted HR, 1.8; 95% CI, 1.1-3.1), all-cause mortality (adjusted HR, 1.8; 95% CI, 1.4-2.4), and deaths due to infection (adjusted HR, 2.3; 95% CI, 1.2-4.3). In contrast, MI was not affected. The increased risk of cardiovascular events (adjusted HR, 1.5; 95% CI, 1.0-2.1) was explained mainly by the effect of wasting on SCD. Selective patient cohort. Wasting was associated strongly with SCD, but

  14. 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…

  15. 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…

  16. Die regsposisie van die gemolesteerde kind 1

    Directory of Open Access Journals (Sweden)

    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.

  17. Identification of patients at low risk of dying after acute myocardial infarction, by simple clinical and submaximal exercise test criteria.

    Science.gov (United States)

    Campbell, S; A'Hern, R; Quigley, P; Vincent, R; Jewitt, D; Chamberlain, D

    1988-09-01

    A consecutive series of 559 hospital survivors of acute myocardial infarction aged less than 66 years were studied; 93 were designated prospectively as low-risk because they were suitable for early submaximal exercise testing and had none of the following clinical or exercise test 'risk factors': (1) angina for at least one month prior to infarction; (2) symptomatic ventricular arrhythmias, or (3) recurrent ischaemic pain, both after the first 24 h of infarction; (4) cardiac failure; (5) cardiomegaly; and (6) an abnormal exercise test (angina, ST-depression or poor blood pressure response). Altogether 301 patients were exercised; their mortality over a median follow-up of 2.4 years was 10.2%, versus 24.6% in the 258 patients not exercised (P = 0.0005). Absence of clinical 'risk factors' alone, in the exercised patients, identified 156 with a mortality of 5.4% versus 15.6% in the 145 with at least one clinical 'risk factor' (P = 0.004). The fully defined low-risk group comprised 93 of the former patients who had neither clinical nor exercise test 'risk factors'. None of these patients died compared with 19 of those with at least one 'risk factor' (mortality = 14.7%; P = 0.002). Their respective rates of non-fatal reinfarction were similar and never exceeded 5% per annum. Therefore, simple clinical and exercise test criteria can positively identify low-risk patients after infarction in whom secondary prevention may be inappropriate.

  18. Appropriateness of medications prescribed to elderly patients with advanced heart failure and limited life expectancy who died during hospitalization.

    Science.gov (United States)

    Barceló, Montserrat; Torres, Olga; Ruiz, Domingo; Casademont, Jordi

    2014-07-01

    Drug therapy in patients with advanced heart failure and limited life expectancy may be of no benefit or even inappropriate. The aim of this study was to analyze the appropriateness of medication prescribed to patients with advanced heart failure and limited life expectancy, considering as such an expected median survival of less than 6 months. We retrospectively reviewed data on all patients with advanced heart failure who met criteria for limited life expectancy and who died in the geriatric ward of a tertiary hospital over a four-and-a-half-year period. We analyzed treatments prescribed before admission, especially drugs used for prophylaxis or to prolong life. A total of 72 patients were included. The mean age was 85.4 years, and 52.3 % were women. Mean Charlson index was 3.2. Prophylactic medications taken by patients at admission were antiplatelets in 40 patients (55.6 %), oral anticoagulants in 17 (23.6 %), statins in 14 (19.4 %), and osteoporosis medication in nine (12.5 %). Medications taken to prolong survival were angiotensin converting enzyme inhibitors or angiotensin II receptor antagonists in 29 patients (40.3 %). Other medications were iron supplements in 19 patients (26.4 %), vitamins in two (2.8 %), and acetylcholinesterase inhibitors in two (2.8 %). Our results show that patients with advanced heart failure and limited life expectancy were receiving an excessive number of prophylactic medications, drugs to prolong life, and other inappropriate treatments. These findings emphasize the need to review drug therapy in an individualized manner in elderly patients with advanced stages of heart disease and a poor prognosis.

  19. Die Heimkunft

    Directory of Open Access Journals (Sweden)

    Stephen Romer

    2009-05-01

    Full Text Available En hommage amical à René Gallet.Die HeimkunftRuhig glänzen indes die silberen Höhen darüber,Voll mit Rosen ist schon droben der leuchtende Schnee.- HölderlinAnd then one day the young master returnsfrom a dark placeand birdsong leads the wanderer inand the cat yawns and curls againin the headiness of this instantthe house is fragrantwith woodsmoke and honeysucklewhich is a kind of accomplishment.Returning from dogmahome to the humanehe lays asideknapsack, alpenstock and hat,goes straight to t...

  20. Racial variation in the use of life-sustaining treatments among patients who die after major elective surgery.

    Science.gov (United States)

    Hernandez, Roland A; Hevelone, Nathanael D; Lopez, Lenny; Finlayson, Samuel R G; Chittenden, Eva; Cooper, Zara

    2015-07-01

    Although various studies have documented increased life-sustaining treatments among racial minorities in medical patients, whether similar disparities exist in surgical patients is unknown. A retrospective cohort study using the Nationwide Inpatient Sample (2006 to 2011) examining patients older than 39 years who died after elective colectomy was performed. Primary predictor variable was race, and main outcome was the use of life-sustaining treatment. In univariate analysis, significant differences existed in use of cardiopulmonary resuscitation (CPR; black, 35.9%; Hispanic, 29.0%; other, 24.5%; white, 11.7%; P = .002) and reintubation (Hispanic, 75.0%; other, 69.0%; black, 52.3%; white, 45.2%; P = .01). In multivariate analysis, black (odds ratio [OR], 3.67; P = .01) and Hispanic (OR, 4.21; P = .03) patients were more likely to have undergone CPR, and Hispanic patients (OR, 4.24; P = .01) were more likely to have been reintubated (reference: white). Blacks and Hispanics had increased odds of experiencing CPR, and Hispanics were more likely to have been reintubated before death after a major elective operation. These variations may imply worse quality of death and increased associated costs. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Hope, Life, and Death: A Qualitative Analysis of Dying Cancer Patients' Talk about Hope

    Science.gov (United States)

    Eliott, Jaklin A.; Olver, Ian N.

    2009-01-01

    Although deemed vital to patient well-being, hope in persons who are terminally ill is often thought to be problematic, particularly when centered on cure. As part of a study on end-of-life decision-making, we asked 28 patients with cancer, believed to be within weeks of their death, to talk about hope. Responses were transcribed and discursively…

  2. Residents Learning from a Narrative Experience with Dying Patients: A Qualitative Study

    Science.gov (United States)

    Tait, Glendon R.; Hodges, Brian D.

    2013-01-01

    For patients at the end of life, it is crucial to address the psychological, existential, and spiritual distress of patients. Medical education research suggests trainees feel unprepared to provide the whole person, humanistic care held as the ideal. This study used an empirically based narrative intervention, the dignity interview, as an…

  3. 'Unbearable suffering': a qualitative study on the perspectives of patients who request assistance in dying

    NARCIS (Netherlands)

    Dees, M.K.; Vernooij-Dassen, M.J.F.J.; Dekkers, W.J.M.; Vissers, K.C.P.; Weel, C. van

    2011-01-01

    Background One of the objectives of medicine is to relieve patients' suffering. As a consequence, it is important to understand patients' perspectives of suffering and their ability to cope. However, there is poor insight into what determines their suffering and their ability to bear it. Purpose To

  4. Dying patients' thoughts of ending their lives: a pilot study of rural New Mexico.

    Science.gov (United States)

    Birkholz, Gloria; Gibson, Joan McIver; Clements, Paul T

    2004-08-01

    Forty-nine hospice patients in rural New Mexico were directly interviewed concerning their thoughts about ending their lives. Thirty-one patients (63%) did not have thoughts of ending their lives, whereas 18 patients (37%) reported having suicidal thoughts. There were no differences between patients with and without thoughts of suicide related to gender; ethnicity; age; education; disease; religion; importance of religion; location of hospice agency; remaining financial, family, or spiritual issues; satisfaction with hospice care; sum of hospice personnel seen; or sum of medical equipment used. There were significant differences between patients with and without thoughts of suicide related to the number of household members (p = .02); the symptoms of trouble sleeping (p = .04) and nervousness (p =.03); and Medicare insurance coverage for hospice care (p =.01). No other symptom, including pain and hopelessness, was significant. Seven (39%) of the 18 patients who thought of ending their lives told someone about these thoughts. There were no variable differences between patients who did and did not tell someone about these thoughts.

  5. Thanatophobia in medical students: approach to death and dying patients attitude scale (ADDPAS) for undergraduate years in medicine.

    Science.gov (United States)

    Kavas, Mustafa Volkan; Oztuna, Derya

    2011-12-01

    In recent decades growing efforts in Western countries in integrating end-of-life care issues into undergraduate medical education have been conspicuous. However, studies in this field are limited in Turkey. We aimed, therefore, as a first step, to develop an attitude scale in order to obtain objective data regarding medical students' approaches to death and dying patients. After applying the scale on medical students and performing exploratory factor analysis, it was found out to be composed of a two-dimensional structure. Then the internal construct validity of these dimensions was subjected to Rasch analysis and the reliability of them was tested by internal consistency and person separation index. As a result of overall analyses, we suggest a new scale which is capable of making valid and reliable measurements.

  6. Euthanasia--again. "Letting die" is not in the patient's best interests: a case for active euthanasia.

    Science.gov (United States)

    Kuhse, H

    1985-05-27

    Recent discussions in the Journal on the subject of euthanasia have relied on intuitive appeals to distinctions traditionally considered to be morally relevant, such as the distinction between acts and omissions (or killing and letting die), or ordinary and extraordinary means of treatment. These discussions remained inconclusive. However, the question of euthanasia no longer remains inconclusive if one adopts the perspective suggested by the United States President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research and by the World Medical Assembly--that a doctor should act in his or her patient's best interests. From this vantage point, it is argued, there will be instances when active euthanasia is the proper cause of action.

  7. Living and dying with dignity in Chinese society: perspectives of older palliative care patients in Hong Kong.

    Science.gov (United States)

    Ho, Andy Hau Yan; Chan, Cecilia Lai Wan; Leung, Pamela Pui Yu; Chochinov, Harvey Max; Neimeyer, Robert A; Pang, Samantha Mei Che; Tse, Doris Man Wah

    2013-07-01

    the empirical Dignity Model has profoundly influenced the provision of palliative care for older terminally ill patients in the West, as it provides practical guidance and intervention strategies for promoting dignity and reducing distress at the end-of-life. to examine the concept of 'living and dying with dignity' in the Chinese context, and explore the generalisability of the Dignity Model to older terminal patients in Hong Kong. using qualitative interviews, the concept of dignity was explored among 16 older Chinese palliative care patients with terminal cancer. Framework analysis with both deductive and inductive methods was employed. the three major categories of themes of the Dignity Model were broadly supported. However, the subtheme of death anxiety was not supported, while two subthemes of generativity/legacy and resilience/fighting spirit manifested differently in the Chinese context. Furthermore, four new emergent themes have been identified. They include enduring pain, moral transcendence, spiritual surrender and transgenerational unity. these findings highlight both a cultural and a familial dimension in the construct of dignity, underline the paramount importance of cultural awareness and competence for working with ethnically diverse groups, and call for a culturally sensitive and family oriented approach to palliative care interventions with older Chinese terminal patients.

  8. [To kill, let die and euthanasia in the bill of rights of patients and in the Chilean doctrine].

    Science.gov (United States)

    Figueroa G, Rodolfo

    2011-05-01

    The Bill of Rights for Patients provides the patient with autonomy for disposing of his life, enabling him to reject those treatments that unnecessarily prolong his life. However, the bill does not allow an artificial acceleration of death. Therefore, the bill does not permit euthanasia (at least, certain form of it) nor assisted-suicide. However, according to the practice of medicine and also Chilean doctrine, it is permitted to inject morphine to a patient to relieve his pain, even though that could hasten his death. In consequence, it is allowed for the patient to dispose of his life and also to inject in him morphine for pain relief, endangering his life, but neither euthanasia nor assisted-suicide is allowed. Is this coherent? According to Chilean doctrine, it could be coherent under the condition of accepting the distinction between killing and letting die and also the double effect doctrine. The problem is that there is abundant English literature in the realm of moral philosophy to disregard both conditions. Therefore, it is possible to claim that the Bill is not coherent and that the Chilean doctrine is based upon a distinction and a doctrine that are not acceptable.

  9. Calvyn en die Skrifgesag

    Directory of Open Access Journals (Sweden)

    L. F. Schulze

    1980-06-01

    Full Text Available Die probleem van die Skrifgesag het die (teologiese geeste nog altyd in beroering — vandag (ná die Aufklarung! nog meer as gedurende die sestiende eeu. Gedurende die laaste paar jaar is ons in Suid-Afrika hardhandig uit ons isolement geruk en skielik lewensgroot gekonfronteer met die probleem van die Skrifgesag.

  10. Learning from dying patients during their final days: life reflections gleaned from dignity therapy.

    Science.gov (United States)

    Hack, Thomas F; McClement, Susan E; Chochinov, Harvey M; Cann, Beverley J; Hassard, Thomas H; Kristjanson, Linda J; Harlos, Mike

    2010-10-01

    Dignity therapy is a novel therapeutic approach designed to decrease suffering, enhance quality of life and bolster a sense of dignity for patients approaching death. The benefits of dignity therapy were previously documented in a sample of 100 terminally ill patients. One of the products of dignity therapy is a transcript of the edited therapy session(s). In this qualitative study, 50 of the 100 (17 from Winnipeg, Manitoba, Canada, and 33 from Perth, Australia) dignity therapy transcripts were randomly drawn, and independently coded and analysed by three investigators using a grounded theory approach. The transcripts revealed that dignity therapy serves to provide a safe, therapeutic environment for patients to review the most meaningful aspects of their lives in such a manner that their core values become apparent. The most common values expressed by the patients included 'Family', 'Pleasure', 'Caring', 'A Sense of Accomplishment', 'True Friendship', and 'Rich Experience'. Exemplars of each of these values illustrate the pervasive, defining role of values in our lives. The findings are discussed in terms of values theory, the role of dignity therapy, and consideration of values clarification in clinicians' efforts to enhance the dignity of terminally ill patients.

  11. Inflammation's Association with Metabolic Profiles before and after a Twelve-Week Clinical Trial in Drug-Naive Patients with Bipolar II Disorder.

    Directory of Open Access Journals (Sweden)

    Sheng-Yu Lee

    Full Text Available Inflammation is thought to be involved in the pathophysiology of bipolar disorder (BP and metabolic syndrome. Prior studies evaluated the association between metabolic profiles and cytokines only during certain mood states instead of their changes during treatment. We enrolled drug-naïve patients with BP-II and investigated the correlation between changes in mood symptoms and metabolic indices with changes in plasma cytokine levels after 12 weeks of pharmacological treatment. Drug-naïve patients (n = 117 diagnosed with BP-II according to DSM-IV criteria were recruited. Metabolic profiles (cholesterol, triglyceride, HbA1C, fasting serum glucose, body mass index (BMI and plasma cytokines (TNF-α, CRP, IL-6, and TGF-β were measured at baseline and 2, 8, and 12 weeks post-treatment. To adjust within-subject dependence over repeated assessments, multiple linear regressions with generalized estimating equation methods were used. Seventy-six (65.0% patients completed the intervention. Changes in plasma CRP were significantly associated with changes in BMI (P = 1.7E-7 and triglyceride (P = 0.005 levels. Changes in plasma TGF-β1 were significantly associated with changes in BMI (P = 8.2E-6, cholesterol (P = 0.004, and triglyceride (P = 0.006 levels. However, changes in plasma TNF-α and IL-6 were not associated with changes in any of the metabolic indices. Changes in Hamilton Depression Rating Scale scores were significantly associated with changes in IL-6 (P = 0.003 levels; changes in Young Mania Rating Scale scores were significantly associated with changes in CRP (P = 0.006 and TNF-α (P = 0.039 levels. Plasma CRP and TGF-β1 levels were positively correlated with several metabolic indices in BP-II after 12 weeks of pharmacological intervention. We also hypothesize that clinical symptoms are correlated with certain cytokines. These new findings might be important evidence that inflammation is the pathophysiology

  12. Aspekte van die siekepastoraat

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    H. J. C. Pieterse

    1980-06-01

    Full Text Available Die siekepastoraat vra ons aandag in hierdie tyd omdat die versorging van siekes ’n kenmerk is van die koms van die koninkryk van God. God se barmhartigheid het in sy volheid tot gelding gekom in die optrede van Jesus Christus. Die volle seën van die heil van die Ryk van God hou ook die versorging van die siekes in. Deur die heilswerk van Christus sien die blindes weer, loop die kreupeles, word melaatses gereinig, hoor die dowes, word dooies opgewek (Luk. 7:22.

  13. To speak, or not to speak -- do clinicians speak about dying and death with geriatric patients at the end of life?

    Science.gov (United States)

    Lenherr, Gabriel; Meyer-Zehnder, Barbara; Kressig, Reto W; Reiter-Theil, Stella

    2012-04-05

    Research describing healthcare professionals' conversations about issues of dying and death with chronically ill geriatric patients is rare, especially in Europe. The study reviews the willingness and difficulties of physicians and nurses to speak about dying and death with geriatric patients. Interview study with 14 physicians and 17 nurses. The majority (21/31) of the interviewed physicians and nurses reported a considerable willingness to speak about dying and death with patients approaching the end of life. Obstacles to addressing this topic included external circumstances such as lack of time and/or privacy (14/31); personal reasons, such as feeling confronted with one's own mortality (12/31); resistance or denial in their patients (12/31); and the cognitive state of the patients (7/31). Discussing and preparing (the patient) for an end-of-life decision early enough is a prerequisite of good palliative care. It is an ethical obligation on the side of the healthcare professionals to support openness, respect for autonomy, and dignity by addressing issues of dying and death with the patient in order to help facilitate advance care planning.

  14. Communicating with dying patients: a time to listen more than talk.

    Science.gov (United States)

    Nyatanga, Brian

    2012-08-01

    Effective communication is central to showing empathy at the end of someone's life, yet it is also perhaps the most difficult skill to get right. As a result, communication is one of the aspects of care that patients most often complain about (Healthcare Commission, 2007). It is widely accepted that effective communication is resource and time-intensive, although the benefits tend to outweigh these perceived drawbacks. More importantly, poor communication can have an impact on patients' decision-making in preparation for death.

  15. Die prediking oor die historiese stof van die Ou Testament

    Directory of Open Access Journals (Sweden)

    F. N. Lion-Cachet

    1989-06-01

    Full Text Available Uit ’n steekproef wat gedoen is uit die preke wat in Die Kerkblad (1986- 1987 verskyn het, blyk dit dat 40% van hierdie preke historiese stof uit die Ou Testament as teks gebruik het.

  16. Die gesag van die Heilige Skrif

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    S.C.W. Duvenage

    1967-03-01

    Full Text Available Dit geld nie maar t.o.v. ’n ongeloofsbeskouing soos dié van Karl Jaspers nie wat beweer: „Die Bibel ist das Depositum eines Jahrtausends menschlicher Grenzerfahrung” of van die Rooms-Katolieke skrifbeskouing nie wat die kerklike leertradisie, soos dogmaties op die konsilie van Trente vasgelê is, beskou as die enigste gesaghebbende kriterium vir die kanonisering en interpretasie van die Skrif.

  17. Imaging techniques and their impact in treatment management of patients with acute flank pain; Die bildgebenden Verfahren und ihre Rolle beim Behandlungsmanagement von Patienten mit akutem Flankenschmerz

    Energy Technology Data Exchange (ETDEWEB)

    Grosse, A.; Grosse, C.A.; Heinz-Peer, G. [Klinik fuer Radiodiagnostik der Medizinischen Universitaet Wien (Austria); Mauermann, J. [Medizinische Universitaet Wien (Austria). Klinik fuer Urologie

    2005-10-01

    The purpose of this overview is to provide a general summary of the imaging techniques applied at the Vienna Hospital for the investigation of acute flank pain and the diagnosis of stone disease and the evaluation of their efficacy and impact on therapy management. The number of publications on the issue of ''intravenous urography (IVU) vs computed tomography (CT)'' is abundant; in recent years, advocates of CT make up the majority. In the Department of Urology at the Vienna Hospital, conventional techniques such as ultrasound and IVU besides UHCT still play an important role. This overview presents the advantages and disadvantages of the various imaging techniques for diagnosis of stone disease and evaluates their significance regarding therapy management of patients with acute flank pain. (orig.) [German] Ziele der Uebersichtsarbeit sind eine zusammenfassende Darstellung der an der Universitaetsklinik fuer Urologie in Wien angewendeten Untersuchungstechniken zur Abklaerung von akutem Flankenschmerz bzw. zur Diagnostik des Steinleidens und die Bewertung ihrer Effizienz und Bedeutung im Therapiemanagement. Die Literatur zum Thema ''intravenoese Urographie (IVU) vs. Computertomographie (CT)'' zur Diagnostik der Urolithiasis bzw. Nephrolithiasis ist reichhaltig. In den letzten Jahren ueberwiegen zunehmend die Befuerworter der CT. An der Universitaetsklinik fuer Urologie in Wien kommen neben der nativen CT weiterhin konventionelle Verfahren wie die Sonographie und die IVU haeufig zum Einsatz. In dieser Arbeit werden die Vorzuege und Nachteile der verschiedenen bildgebenden Verfahren in der Steindiagnostik aufgezeigt und ihr Stellenwert beim therapeutischen Management von Patienten mit akutem Flankenschmerz evaluiert. (orig.)

  18. Are lymphangiograms necessary for patients with seminomatous testicular tumor. Ist die Lymphographie beim Seminom noch aktuell

    Energy Technology Data Exchange (ETDEWEB)

    Kampen, M. van (Klinikum Nuernberg (Germany). Abt. Strahlentherapie); Andreas, P. (Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik); Renner, H. (Klinikum Nuernberg (Germany). Abt. Strahlentherapie)

    1993-04-01

    In the radiotherapist's point of view lymphography and computed tomography scan compete for staging and therapy planning of testicular seminoma. We investigated whether lymphogram can be replaced by computed tomography scan. 114 patients with histologically confirmed seminoma of the testis were treated by radiotherapy from 1978 through 1991. Radiological staging included both computed tomography scan and lymphography in all cases. The results of both methods were similar in 79%. Computed tomography scan led to an upstaging in 4% while lymphography was negative. 17% of the patients showed negative results considering computed tomography scan while lymphogram was positive. In accordance with these data treatment portals or doses were altered in 21%. Using the M.D. Anderson Hospital clinical staging system a stage IIa is not safely identified by computed tomography scan. Just lymphography can safely identify a stage IIa patient. On the other hand, lymphography shows a very high amount of false positive interpretations. However, two conclusions are made: 1. Using a conventional technic (radiation of paraaortal and ipsilateral iliacal region, dose about 30 Gy HD) lymphogram can be superseded by computed tomography scan. 2. In the case of reducing treatment volume and/or dose lymphogram should be added to computed tomography scan. (orig./MG)

  19. Die ontwrigting van die Afrikanervolk en volkseenheid

    Directory of Open Access Journals (Sweden)

    H. du Plessis

    1946-03-01

    Full Text Available Die gevare wat ons Afrikanerdom voor die deur staan, is baie en ernstig. Daar is die gevaar van immigrasie van buitelanders, daar is die al driester geroep om gelykstelling tussen blank en gekleurd, daar is die dreigende oorheersing van ’n oppervlakkige Amerikaanse „jazz”-gees.

  20. Assessment of the quality of life of patients with peripheral vascular diseases; Die Messung der gesundheitsbezogenen Lebensqualitaet bei der peripheren arteriellen Verschlusskrankheit

    Energy Technology Data Exchange (ETDEWEB)

    Wohlgemuth, W.A. [Klinikum Augsburg (Germany). Klinik fuer Diagnostische Radiologie und Neuroradiologie; Bayreuth Univ. (Germany). Inst. fuer Medizinmanagement und Gesundheitswissenschaften; Niechzial, M.; Nagel, E. [Bayreuth Univ. (Germany). Inst. fuer Medizinmanagement und Gesundheitswissenschaften; Bohndorf, K. [Klinikum Augsburg (Germany). Klinik fuer Diagnostische Radiologie und Neuroradiologie

    2003-02-01

    The Medical Outcome Short Form 36 is commonly used as a generic quality of life measure in the assessment of vascular disease. The Claudication Scale CLAU-S, the PAVK-86 Fragebogen, and the Walking Impairment Questionnaire WIQ are validated disease-specific questionnaires for intermittent claudication. A disease specific tool for critical ischaemia is lacking. Quality of life of patients with peripheral arterial occlusive disease is not only impaired in the physical functioning domains (mobility, self care, activities of daily living), but moreover in their social and emotional wellbeing. This situation worsens under conservative treatment. Angioplasty and operation procedure similar improvements in all dimensions of hrQOL. As radiological interventional procedures just aim to improve hrQOL and do not bring a definite cure for the underlying disease, patients perception of their quality of life should be taken into account both in the indication for angioplasty and for the scientific evaluation of new treatment modalities. (orig.) [German] Mit dem sog. Short-Form 36 (SF-36) existiert bei der peripheren arteriellen Verschlusskrankheit (pAVK) ein anerkanntes mehrdimensionales Messinstrument der Lebensqualitaet ergaenzt durch drei validierte krankheitsspezifische Messinstrumente (Claudication Scale CLAU-S, Fragebogen PAVK-86, Walking Impairment Questionnaire WIQ), die die krankheisspezifischen Probleme der Claudicatio intermittens untersuchen. Ein krankheitsspezifisches Messinstrument fuer die kritische Ischaemie fehlt bisher. Schaetzen pAVK-Patienten ihre Lebensqualitaet selbst ein, so fuehlen sie diese nicht nur aufgrund reduzierter koerperlicher Funktionen (Mobilitaetseinschraenkungen, haeusliche Verrichtungen, Koerperpflege u.a.) und Schmerzen beeintraechtigt. Auch Schlaf, soziales und emotionales Wohlbefinden (Aengstlichkeit, Antriebsschwaeche) sind stark mitbetroffen. Alle Ergebnisse deuten darauf hin, dass sich die Lebensqualitaet bei der pAVK unter einer

  1. Alcoholics anonymous and other twelve-step programs in recovery.

    Science.gov (United States)

    Detar, D Todd

    2011-03-01

    Recovery is a new way of life for many patients; a life without substances to alter their moods but with a major change improving the physical, psychological, and emotional stability with improved overall health outcomes. The Twelve Steps of the Alcoholics Anonymous (AA) are the foundation of the AA, describing both the necessary actions and the spiritual basis for the recovery program of the AA. The Twelve Steps of the AA provide a structure for which a patient with alcoholism may turn for an answer to their problem of alcohol use, abuse, or dependence. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. 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

    2016-12-28

    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.

  3. 50% adherence of patients suffering chronic conditions – where is the evidence? [50% Adhärenz bei Patienten mit chronischen Erkrankungen – wo ist die Evidenz?

    Directory of Open Access Journals (Sweden)

    Mathes, Tim

    2012-11-01

    Full Text Available [english] The World Health Organization states that in a widespread report that “in developed countries, adherence among patients suffering chronic diseases averages only 50%”. We followed the quoted references to this statement. The data basis for this statement is one randomized controlled trial (RCT on hypertensive steel workers in Canada published in 1975 and one study dealing with neurotic outpatients in Pennsylvania, USA published in 1965. Both studies are not suitable to assume such generalized adherence estimation and are not for different reasons transferable to today’s patient care.[german] Die Weltgesundheitsorganisation (WHO gibt in einem sehr verbreiteten Bericht an, dass die Therapietreue bei Patienten mit chronischen Erkrankungen bei durchschnittlich 50% in entwickelten Ländern liegt. Wir haben anhand der Literaturhinweise die Basis dieser Aussage verfolgt. Die Basis dieser Aussage ist lediglich eine randomisierte kontrollierte Studie (RCT an kanadischen Stahlarbeitern mit Hypertension von 1975 sowie eine US-amerikanische Studie an neurotischen Patienten von 1965. Beide Studien sind nicht geeignet eine derart generalisierte Aussage zu treffen und darüber hinaus nicht auf die gegenwärtige Patientenversorgung übertragbar.

  4. Botox, tratamiento fútil en pacientes menores de doce años de edad con espasticidad Botox: A futile treatment for patients under twelve years of age suffering from muscle spasticity

    Directory of Open Access Journals (Sweden)

    Lira López Lirled

    2008-08-01

    Full Text Available El artículo sostiene la futilidad del Botox cuando éste se aplica en pacientes menores de doce años de edad con espasticidad, basándose principalmente en estudios realizados por diversos investigadores que plantean el actuar del fármaco sobre el cuerpo. Al tiempo que propone ampliar la visión en la atención de la discapacidad, partiendo de la persona como un ser integral, ubicándolo en su historia personal, en sus capacidades y etapa de la vida en que se encuentra, sin que se restrinja solo a la corporeidad del paciente. Plantea que los pacientes menores de doce años con espasticidad son personas que se encuentran en proceso de desarrollar sus capacidades y potencializarlas, la espasticidad se manifiesta por una triada: hipertonía, hiperrreflexia y reflejos patológicos, lo que limita la movilidad pero no la obstruye. Es resultado de la secuela de una lesión en las vías córtico espinales, por lo que el tratamiento debe de ir más allá de las expresiones corporales que el paciente hace evidente durante la realización de movimientos voluntarios.The following article presents the research of multiple investigators about the futility of Botox when this drug is applied on patients younger than twelve years old and the effects of the body of the subjects. At the same time invites to amply the vision on the attention of disability, taking the person as a complete being, placing his or hers personal history, his or hers capacities and the life phase he or she is living actually. Also shows that the patients with spasticity younger than twelve years old are people who is on process of developing his or hers capabilities and potencialize them, the spasticity is a sequel of injury on cortical spinal routes that manifest hypertonic, hiperreflex and pathologic reflexes that limit the mobility but do not impede it, so the treatment must be beyond corporal expressions that the patient made evident during the voluntary movement realization.

  5. Die Nasionale Vakterminologiediens (NVD

    Directory of Open Access Journals (Sweden)

    L. A. Genis

    1992-07-01

    Full Text Available Die Nasionale Vakterminologiediens (NVD ressorteer onder die Hoofdirektoraat Kultuur en Vakkundige Hulp- dienste van die Departement van Nasionale Opvoeding. Die hoofdoelwit van die NVD is die skepping van ’n fijnksionele vakwoordeskat in veral Afrikaans, parallel met die inter- nasionaal gebruikte terminologieë.

  6. Hospice assist at home : does the integration of hospice care in primary healthcare support patients to die in their preferred location - A retrospective cross-sectional evaluation study

    NARCIS (Netherlands)

    de Graaf, Everlien; Zweers, Daniëlle; Valkenburg, Anna Ch; Uyttewaal, Allegonda; Teunissen, Saskia Ccm

    2016-01-01

    BACKGROUND: A majority of patients prefer to die at home. Specialist palliative care aims to improve quality of life. Hospice assist at home is a Dutch model of general/specialised palliative care within primary care, collaboratively built by general practitioners and a hospice. AIM: The aims of thi

  7. 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

    Energy Technology Data Exchange (ETDEWEB)

    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

  8. Die kritiese taak van die literator

    Directory of Open Access Journals (Sweden)

    A. L. Combrink

    1981-05-01

    Full Text Available Die beoefening van die literêre kritiek was aanvanklik slegs ’n deeltydse aktiwiteit. Die vroegste literêre kritici was nie as sodanig kritici nie maar het as deel van hulle totale intellektuele aktiwiteit hulle ook uitgelaat oor die letterkunde. Die motivering wat hulle hiertoe gehad het sou in ons dag heeltemal verdag voorkom: ’n uitgesproke didaktiese of moraliserende houding was die reel.

  9. Patients with neuromyelitis optica have a more severe disease than patients with relapsingremitting multiple sclerosis, including higher risk of dying of a demyelinating disease

    Directory of Open Access Journals (Sweden)

    Denis Bernardi Bichuetti

    2013-05-01

    Full Text Available Although neuromyelitis optica (NMO is known to be a more severe disease than relapsing-remitting multiple sclerosis (RRMS, few studies comparing both conditions in a single center have been done. Methods: Comparison of our previously published cohort of 41 NMO patients with 177 RRMS patients followed in the same center, from 1994 to 2007. Results: Mean age of onset was 32.6 for NMO and 30.2 for RRMS (p=0.2062 with mean disease duration of 7.4 years for NMO and 10.3 years for RRMS. Patients with NMO had a higher annualized relapse rate (1.0 versus 0.8, p=0.0013 and progression index (0.9 versus 0.6, p≪0.0001, with more patients reaching expanded disability status scale (EDSS 6.0 (39 versus 17%, p=0.0036. The odds ratio for reaching EDSS 6.0 and being deceased due to NMO in comparison to RRMS were, respectively, 3.14 and 12.15. Conclusion: Patients with NMO have a more severe disease than patients with RRMS, including higher risk of dying of a demyelinating disease.

  10. Die Via Dolorosa

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    W. J. van der Merwe

    1957-03-01

    Full Text Available In die hartjie van Jerusalem, die heilige stad vir Jood, Mohammedaan en Christen staan daar ’n boog, die ,,Ecce Homoboog” genaamd, en 'n klein endjie daarvandaan, die Heilige Grafkerk.

  11. Luther die prediker

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    J. J. van der Walt

    1983-06-01

    Full Text Available ’n Prediker moet ’n getroue herder wees wat magtig is in die Heilige Skrif, want die Woord bring die kerk voort. Daarom moet die prediker in sy bediening aan mense ’n woord van sekerheid hê deur seker te wees hy het die Woord van God. Met hierdie gedagtegang het Luther se pastorale besorgdheid vaste bodem vir die prediking in die gesag van die Woord van God.

  12. Concepts of mental capacity for patients requesting assisted suicide: a qualitative analysis of expert evidence presented to the Commission on Assisted Dying.

    Science.gov (United States)

    Price, Annabel; McCormack, Ruaidhri; Wiseman, Theresa; Hotopf, Matthew

    2014-04-22

    In May 2013 a new Assisted Dying Bill was tabled in the House of Lords and is currently scheduled for a second reading in May 2014. The Bill was informed by the report of the Commission on Assisted Dying which itself was informed by evidence presented by invited experts.This study aims to explore how the experts presenting evidence to the Commission on Assisted Dying conceptualised mental capacity for patients requesting assisted suicide and examine these concepts particularly in relation to the principles of the Mental Capacity Act 2005. This study was a secondary qualitative analysis of 36 transcripts of oral evidence and 12 pieces of written evidence submitted by invited experts to the Commission on Assisted Dying using a framework approach. There was agreement on the importance of mental capacity as a central safeguard in proposed assisted dying legislation. Concepts of mental capacity, however, were inconsistent. There was a tendency towards a conceptual and clinical shift toward a presumption of incapacity. This appeared to be based on the belief that assisted suicide should only be open to those with a high degree of mental capacity to make the decision.The 'boundaries' around the definition of mental capacity appeared to be on a continuum between a circumscribed legal 'cognitive' definition of capacity (in which most applicants would be found to have capacity unless significantly cognitively impaired) and a more inclusive definition which would take into account wider concepts such as autonomy, rationality, voluntariness and decision specific factors such as motivation for decision making. Ideas presented to the Commission on Assisted Dying about mental capacity as it relates to assisted suicide were inconsistent and in a number of cases at variance with the principles of the Mental Capacity Act 2005. Further work needs to be done to establish a consensus as to what constitutes capacity for this decision and whether current legal frameworks are able to

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

    Directory of Open Access Journals (Sweden)

    Tan Amy

    2013-01-01

    Full Text Available Abstract Background 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. Methods 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. Results 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

  14. 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

  15. A Study of Meeting the Emotional Needs of Dying Patients and their Families at Walter Reed Army Medical Center, Washington, DC

    Science.gov (United States)

    1981-08-01

    for the creation of a special thanatology team called "The Care Team". This interdisciplinary team consisting of volunteer physicians, nurses, social...the status quo, (2) establish a fully operational hospice, or (3) establish a thanatology team that is specifically designed to help dying patients... Thanatology Team To some the status quo is not acceptable, yet at the same time establishing a fully operational hospice at Walter Reed Army Medical Center

  16. Wêreldmededingendheid en die tegnologie

    Directory of Open Access Journals (Sweden)

    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.

  17. Mixed-Strain Mycobacterium tuberculosis Infections among Patients Dying in a Hospital in KwaZulu-Natal, South Africa▿

    OpenAIRE

    Cohen, Ted; Wilson, Douglas; Wallengren, Kristina; Samuel, Elizabeth Y.; Murray, Megan

    2010-01-01

    We performed spoligotyping and 24-locus mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) typing on M. tuberculosis culture-positive biopsy specimens collected from adults dying in a hospital in KwaZulu-Natal. Of 56 culture-positive samples genotyped, we detected mixed strains in five (9%) and clonal heterogeneity in an additional four (7%).

  18. Genotyping of Toxoplasma gondii: DNA extraction from formalin-fixed paraffin-embedded autopsy tissues from AIDS patients who died by severe disseminated toxoplasmosis.

    Science.gov (United States)

    Bastos da Silva, Inara; Batista, Tatiana Pimental de Andrade; Martines, Roosecelis Brasil; Kanamura, Cristina Takami; Ferreira, Isabelle Martins Ribeiro; Vidal, Jose Ernesto; Pereira-Chioccola, Vera Lucia

    2016-06-01

    This study investigated the genetic features of Toxoplasma gondii isolated directly in autopsies of HIV-infected patients who died with severe disseminated toxoplasmosis. This retrospective analysis was conducted in a cohort of 15 HIV-infected patients with clinical and laboratory data. They had previous cerebral toxoplasmosis at least 6 months before the disseminated toxoplasmosis episode. The hypothesis was that they were infected with highly virulent parasites due to the condition in which they died. T. gondii genotyping was done directly in DNA extracted from 30 autopsy brain and lung samples (2 per patient) and mutilocus PCR-RFLP genotyping was done using 12 molecular markers. The 30 clinical samples were genotyped successfully in 8 or more loci and six suggestive genotypes were identified. One of them was Toxo DB #11, previously identified in different domestic animals and virulent in experimental animals. The other five suggestive genotypes identified in 14 patients were not described. TgHuDis1 was the most frequent and was determined in 8 patients. TgHuDis3 and TgHuDis5 were identified in two patients each. TgHuDis2 and TgHuDis4 have been identified in one patient each. These suggestive genotypes could be considered as virulent, since they caused severe tissue damage and had similar characteristics as Toxo # DB 11.

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

    Directory of Open Access Journals (Sweden)

    G. J. Oosthuizen

    1980-11-01

    Full Text Available The motivation of the Black worker can not be studied in isolation since the White worker still holds many executive positions and therefore has an influence on the Black workers' motivation. The role of the White worker in motivating the Black worker in a specific organisation and the attitude and leadership approach of the White worker on the existence/nonexistence and relative satisfaction of the needs of Black workers are discussed.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.

  20. Die verbondeling in verband

    Directory of Open Access Journals (Sweden)

    J. A.L. Taljaard

    1964-03-01

    Full Text Available Daar is dikwels en deur groot outoriteite al geskryf oor die mens in die samelewing. Hier wil ons egter die saak probeer aanraak uit ’n nuwe hoek, veral om die Skrifbeligting van die siening te benader. Vanselfsprekend verg hierdie benaming ’n skrifmatige mensbeskouing, maar ook ’n skrifmatige verbandsbeskouing. Die mens staan egter nie slegs in verhouding tot sy medemens nie maar ook in verhou­ ding tot stof, plant en dier. Boweal staan die mens in verhouding tot God, en hierdie verhouding is deurslaggewend vir al die ander verhoudinge waarin die mens hom bevind. Tog staan die mens ook in verhouding tot homself; wie kan die diepere roersele van die menslike siel peil, wie weet van die wroeginge, vreugde, leed en genot van die mens beter as hyself? Ook hierdie aspek verdien ons aandag. Op volledigheid kan nie aanspraak gemaak word nie, dit is ook nie my bedoeling nie. Die bedoeling is maar om die omvang van die tema aan te dui, die gedagtes te prikkel en veral om aan te spoor tot nuwe denkoriëntering waarin ook terminologies gebreek behoort te word met die neo-skolastiek binne reformatoriese lyn.

  1. The twelve theses: a call to a new reformation

    Directory of Open Access Journals (Sweden)

    John Shelby Spong

    2015-03-01

    Full Text Available With every discovery emerging from the world of science over the last 500 years concerning the origins of the universe and of life itself, the traditional explanations offered by the Christian Church appeared to be more and more dated and irrelevant.  Christian leaders, unable to embrace the knowledge revolution seemed to believe  that the only way to save Christianity was not to disturb the old patterns either by listening to, much less by entertaining the new knowledge. I tried to articulate this challenge in a book entitled: Why Christianity Must Change or Die, published in 1998.  In that book I examined in detail the issues that I was convinced Christianity must address. Shortly after that book was published I reduced its content to twelve theses, which I attached in Luther-like fashion to the great doors on the Chapel of Mansfield College at Oxford University in the United Kingdom. I then mailed copies of those Twelve Theses to every acknowledged Christian leader of the world. It was an attempt to call them into a debate on the real issues that I was certain the Christian Church now faced.  I framed my twelve theses in the boldest, most provocative language possible, designed primarily to elicit response and debate. I welcome responses from Christians everywhere.  I claim no expertise or certainty in developing answers, but I am quite confident that I do understand the problems we are facing as Christians who are seeking to relate to the 21st century.

  2. Wege in die Zukunft

    Science.gov (United States)

    Kauermann, Göran; Mosler, Karl

    Die Zukunft stellt große Herausforderungen an die Arbeit der Deutschen Statistischen Gesellschaft. Sie betreffen die gestiegenen Anforderungen der Nutzer von Statistik, die Kommunikationsmöglichkeiten des Internets sowie die Dynamik der statistischen Wissenschaften und ihrer Anwendungsgebiete. Das Kapitel 5 beschreibt, wie sich die Gesellschaft diesen Herausforderungen stellt und welche Ziele sie sich in der wissenschaftlichen Zusammenarbeit und im Kampf gegen das Innumeratentum gesetzt hat.

  3. Die Gewalt der Frauen

    Directory of Open Access Journals (Sweden)

    Angelika Ebrecht

    2000-07-01

    Full Text Available Anhand historischer Beispiele aus der Zeit der letzten Jahrhundertwende in Europa stellt die Autorin den Zusammenhang von Transgression, Aggression und Inversion dar. Gegen die gängige Auffassung, Gewalt sei männlich, setzt sie Selbst- und Fremdentwürfe von Frauen, die als Duellantinnen, Soldatinnen und Mörderinnen die gesellschaftlich festgelegten Grenzen der Gewalt verletzten. Sie interpretiert dies als Versuch, die Geschlechtergrenzen zu überschreiten und sich eine Subjektposition anzueignen.

  4. Dying from cardiac tamponade

    Directory of Open Access Journals (Sweden)

    Powari Manish

    2007-09-01

    Full Text Available Abstract Background To determine the causes of cardiac tamponade (CT, focussing especially on haemopericardium (HP, as a terminal mode of death, within a 430,000 rural English population. Methods Our hospital mortuary register and, all postmortem reports between 1995 and 2004 inclusive, were interrogated for patients dying of CT or HP. The causes of CT/HP and selected morphological characteristics were then determined. Results 14,368 postmortems were performed in this period: of these, 461 patients died of CT. Three cases were due to non-haemorrhagic pericardial effusion. HP accounted for the remaining 458 cases of which, five were post-traumatic, 311 followed rupture of an acute myocardial infarction (RAMI, 138 after intra-pericardial rupture of dissecting ascending aortic aneurysms (RD3A and four were due to miscellaneous causes. HP was more commonly due to RAMI. Men tended to die from RAMI or RD3A earlier than women. RAMI or RD3A were commoner in men Two thirds of RAMI were associated with coronary artery thrombosis. Anterior free wall rupture was commonest overall, and in women, but posterior free wall rupture was commoner in men. The volume of intrapericardial blood in RAMI (mean = 440 ml and RD3A (mean = 498 ml varied between 150 and 1000 ml: intrapericardial blood volume was greater in men than in women dying from either RAMI or RD3A. Conclusion At postmortem, CT is most often related to HP, attributable to either RAMI or intrapericardial RD3A. Post-traumatic and other causes of CT are infrequent.

  5. Materials on dies for pressure die casting

    Directory of Open Access Journals (Sweden)

    E. Ragan

    2012-01-01

    Full Text Available In the contribution the stress of die materials of thermal fatigue is defi ned and material life is derived theoretically and compared with the measured values. The important properties of the die materials as thermal conductivity, coeffi cient of thermal expansivity, modulus of elasticity and mechanical properties are described. Binding to it single die materials as carbon steels and chrome-tungsten steels are analyzed. As the perspective die material for pressure die casting of ferrous metals appears molybdenum with regard to advantageous properties.

  6. Antiglobalisierung die Andere Globalisierung

    OpenAIRE

    Ljiljana Croce

    2006-01-01

    Das Ziel der Arbeit ist, ein je größeres Interesse an diesem Thema zu erwecken und auf die Gefahren hinzuweisen, denen wir alle verlaufen, wie die Armen, sowie auch die Reichen und die kleine Gruppe der zum mittleren Stand gehörenden, die immer mehr in die offene Armut versinken. Es wäre zu viel, in einer Welt solcher Globalisierung, die soziale Empfi ndlichkeit der Menschen zueinander zu erwarten. In Wirklichkeit geht sie immer mehr verloren. Der Mensch als Einzelperson, sowie auch die Völke...

  7. 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

  8. What a wish to die can mean: reasons, meanings and functions of wishes to die, reported from 30 qualitative case studies of terminally ill cancer patients in palliative care.

    Science.gov (United States)

    Ohnsorge, Kathrin; Gudat, Heike; Rehmann-Sutter, Christoph

    2014-01-01

    Despite research efforts over recent decades to deepen our understanding of why some terminally ill patients express a wish to die (WTD), there is broad consensus that we need more detailed knowledge about the factors that might influence such a wish. The objective of this study is to explore the different possible motivations and explanations of patients who express or experience a WTD. Thirty terminally ill cancer patients, their caregivers and relatives; from a hospice, a palliative care ward in the oncology department of a general hospital, and an ambulatory palliative care service; 116 semi-structured qualitative interviews analysed using a complementary grounded theory and interpretive phenomenological analysis approach. THREE DIMENSIONS WERE FOUND TO BE CRUCIAL FOR UNDERSTANDING AND ANALYSING WTD STATEMENTS: intentions, motivations and social interactions. This article analyses the motivations of WTD statements. Motivations can further be differentiated into (1) reasons, (2) meanings and (3) functions. Reasons are the factors that patients understand as causing them to have or accounting for having a WTD. These reasons can be ordered along the bio-psycho-socio-spiritual model. Meanings describe the broader explanatory frameworks, which explain what this wish means to a patient. Meanings are larger narratives that reflect personal values and moral understandings and cannot be reduced to reasons. Functions describe the effects of the WTD on patients themselves or on others, conscious or unconscious, that might be part of the motivation for a WTD. Nine typical 'meanings' were identified in the study, including "to let death put an end to severe suffering", "to move on to another reality", and - more frequently- "to spare others from the burden of oneself". The distinction between reasons, meanings and functions allows for a more detailed understanding of the motivation for the WTD statements of cancer patients in palliative care situations. Better understanding

  9. Verrekening van die kragveld van die verbond in die inkleding van die kommunikatiewe driehoeksverhouding tussen teks, hoorder en prediker

    OpenAIRE

    2012-01-01

    In hierdie artikel word die kommunikatiewe driehoeksverhouding tussen die Bybelse teks, die hoorders en die prediker homileties verken. Die probleemstelling waarmee gewerk word handel oor potensiële versteurings wat kan plaasvind in hierdie driehoeksverhouding wanneer die hoorders en die prediker in hulle menslike beperktheid in verbinding gebring word met die ewige Woord van God soos dit in die Bybelse teks na vore kom. In die loop van die artikel word die volgende aspekte verken: ’n Ideale...

  10. Hepatic Angiosarcoma: a Review of Twelve Cases

    Institute of Scientific and Technical Information of China (English)

    Qiang Li; Xishan Hao

    2005-01-01

    OBJECTIVE Hepatic angiosarcoma (HAS), a lethal disease, is the most common sarcoma arising in the liver. Little information about the epidemiology, etiology, diagnosis and management of HAS has been reported. Increased familiarity with this disease will facilitate correct diagnosis and help to improve management of this condition in the future.The objective of this study was to describe cases of hepatic angiosarcoma and to discuss the etiologic, diagnostic, therapeutic features and prognosis of this tumor. This report not only serves to give more evidence of the relationship between hepatic angiosarcoma and carcinogenic exposure, but also demonstrates the key points in different methods of diagnosis and the optimal treatment of hepatic angiosarcoma.METHODS Twelve cases of hepatic angiosareoma were analyzed retrospectively, representing the different character in clinical presentations and laboratory computed tomographical scans; pathological data and treatment are described. Clinical and biologic follow-up was carried out for two years after surgical treatment.RESULTS There were nine men and three women varying in ages from 57 to 71 years with an average of 64.3 years. Ten patientshad a history of exposure to vinyl chloride or thorotrast. Mild or moderate abdominal pain and bloating, abdominal mass and fever were the common clinical presentations. Tumors were visualized by ultrasonography and CT scans in all patients. Biochemical profiles yielded variable results and proved to be of little value in detection or diagnosis. Surgical resection was feasible for each patient who was treated as follows: two wedge resections, six segementectomies and four bisegmentectomies. Five patients received Neoadjuvant chemotherapy postoperatively. The survival rate of those cases was poor. The maximum survival time was fourteen months. The mean survival time for this chemotherapeutic group was 11 months. The difference between the survival time of those treated with an operation

  11. Mythematics Solving the Twelve Labors of Hercules

    CERN Document Server

    Huber, Michael

    2009-01-01

    How might Hercules, the most famous of the Greek heroes, have used mathematics to complete his astonishing Twelve Labors? From conquering the Nemean Lion and cleaning out the Augean Stables, to capturing the Erymanthean Boar and entering the Underworld to defeat the three-headed dog Cerberus, Hercules and his legend are the inspiration for this book of fun and original math puzzles. While Hercules relied on superhuman strength to accomplish the Twelve Labors, Mythematics shows how math could have helped during his quest. How does Hercules defeat the Lernean Hydra and stop its heads from multip

  12. Die voorspellingswaarde van die takseersentrum: 'n Oorsig

    Directory of Open Access Journals (Sweden)

    H. J. Pietersen

    1990-06-01

    Full Text Available The assessment centre: a brief review of predictive value. Factors such as the rise of the professional manager, industrialization and worker expectations have, over the last few decades, increasingly placed managers in the limelight as a key occupational group. In this regard the assessment centre has become prominent as a method for the identification of managerial potential. However, a brief review of the relevant research literature indicates low predictive variances for the managerial assessment centre. This fact, together with the limited scope of the assessment centre, therefore necessitates, amongst other things, a wider research perspective which will include other work and non-work related factors as well. Opsomming Verskynsels soos die opkoms van die professionele bestuurder, industrialisering en stygende werkerverwagtinge het meegebring dat die kollig die afgelope paar dekades al hoe meer op bestuurders as sleutelberoepskategone geplaas is. In hierdie verband het veral die takseersentrum aandag gekry as 'n metode vir die identifisering van bestuurs- potensiaal 'n Kort oorsig van die betrokke navorsingsliteratuur toon egter lae voorspellingsvariansiesyfers vir die takseersentrum aan. Hierdie feit, tesame met die beperkte fokus van die takseersentrum, noodsaak, onder andere, 'n wyer navorsingsperspektief wat ook ander relevante werk- en nie-werkverwante faktore msluit.

  13. How safe is magnetic resonance imaging in patients with contraceptive implants; Wie sicher ist die MRT bei Patientinnen mit kontrazeptiven Implantaten

    Energy Technology Data Exchange (ETDEWEB)

    Muehler, M.; Taupitz, M. [Charite - Universitaetsmedizin Berlin (Germany). Institut fuer Radiologie

    2006-07-15

    When patients with an implanted contraceptive device undergo MRI, it must be ensured that the examination involves no risk to the patient (MR safety) and that the diagnosis is not affected by artifacts or the function of the device compromised (MR compatibility). Two basic types of intrauterine devices can be distinguished: the metal-containing/metal-free intrauterine device (IUD) and the hormone-containing implant, the fully metal-free intrauterine system (IUS), as well as the ESSURE insert made of stainless steel, which has been approved for use in Europe since February 2001. The metal-containing and metal-free IUDs and ESSURE are MRI compatible up to a magnetic field strength of 1.5 T. They do not interact in any relevant way with the external magnetic or high-frequency field and the temperature increase is within the physiologic range. The implants merely produce a local signal void with a shape that depends on their orientation relative to the magnetic field lines. At 3 T, only the metal-free IUD and the IUS are MRI safe in terms of the material used. In contrast, metal-containing IUDs and the ESSURE have not yet been fully evaluated in the 3 T field, which is why they represent a contraindication to MRI. No data are available on the MRI compatibility at 3 T for any of these devices. (orig.) [German] Bei der Untersuchung von Patientinnen mit kontrazeptiven Implantaten im MRT muss gewaehrleistet sein, dass es weder zu einer Gesundheitsgefaehrdung der Patientin (MR-Sicherheit) noch zu befundrelevanten Artefakten oder einer Funktionsbeeintraechtigung des Implantats (MR-Kompatibilitaet) kommt. Unterschieden werden im wesentlichen 2 Systeme kontrazeptiver Implantate: Das metallhaltige/-lose Intrauterinpessar (IUP; engl. intrauterine device, IUD) sowie das bauaehnliche, hormontragende, vollstaendig metallfreie intrauterine System (IUS; engl. intrauterine system) und das seit Februar 2001 auf dem europaeischen Markt zugelassene, aus Edelstahl gefertigte ESSURE. Die

  14. Die ontwikkeling van die bestuursmotiveringsvraelys (BMV

    Directory of Open Access Journals (Sweden)

    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

  15. The effectiveness of the Liverpool care pathway in improving end of life care for dying cancer patients in hospital. A cluster randomised trial

    Directory of Open Access Journals (Sweden)

    Pellegrini Fabio

    2011-01-01

    Full Text Available Abstract Background Most cancer patients still die in hospital, mainly in medical wards. Many studies in different countries have shown the poor quality of end-of-life care delivery in hospitals. The Program "Liverpool Care Pathway for the dying patient" (LCP, developed in the UK to transfer the hospice model of care into hospitals and other care settings, is a complex intervention to improve the quality of end-of-life care. The results from qualitative and quantitative studies suggest that the LCP Program can improve significantly the quality of end-of-life care delivery in hospitals, but no randomised trial has been conducted till now. Methods and design This is a randomized cluster trial, stratified by regions and matched for assessment period. Pairs of eligible medical wards from different hospitals will be randomized to receive the LCP-I Program or no intervention until the end of the trial. The LCP-I Program will be implemented by a Palliative Care Unit. The assessment of the end-points will be performed for all cancer deaths occurred in the six months after the end of the LCP-I implementation in the experimental wards and, in the same period of time, in the matched control wards. The primary end-point is the overall quality of end-of-life care provided on the ward to dying cancer patients and their families, assessed using the Global Scale of the Italian version of the Toolkit "After-death Bereaved Family Member Interview". Discussion This study can be interpreted as a Phase III trial according to the Medical Research Council Framework. In this study, the effectiveness of a fully defined intervention is assessed by comparing the distribution of the endpoints in the experimental and in the control arm. Research ID RFPS-2006-6-341619 Trial registration ClinicalTrials.gov Identifier: NCT01081899

  16. Die sestienpersoonlikheidsfaktorvraelys as hulpmiddel by die takseersentrum

    Directory of Open Access Journals (Sweden)

    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.

  17. “The Patient is Dying, Please Call the Chaplain”: The Activities of Chaplains in One Medical Center’s Intensive Care Units

    Science.gov (United States)

    Choi, Philip J.; Curlin, Farr A.; Cox, Christopher E.

    2015-01-01

    Context Patients and families commonly experience spiritual stress during an intensive care unit (ICU) admission. While a majority of patients report that they want spiritual support, little is known about how these issues are addressed by hospital chaplains. Objectives To describe the prevalence, timing, and nature of hospital chaplain encounters in ICUs. Methods This was a retrospective cross-sectional study of adult ICUs at an academic medical center. Measures included: days from ICU admission to initial chaplain visit, days from chaplain visit to ICU death or discharge, hospital and ICU length of stay, severity of illness at ICU admission and chaplain visit, and chart documentation of chaplain communication with the ICU team. Results Of a total of 4169 ICU admissions over six months, 248 (5.9%) patients were seen by chaplains. Of the 246 patients who died in an ICU, 197 (80%) were seen by a chaplain. There was a median of two days from ICU admission to chaplain encounter and a median of one day from chaplain encounter to ICU discharge or death. Chaplains communicated with nurses after 141 encounters (56.9%), but with physicians after only 14 encounters (5.6%); there was no documented communication in 55 encounters (22%). Conclusion In the ICUs at this tertiary medical center, chaplain visits are uncommon and generally occur just before death among ICU patients. Communication between chaplains and physicians is rare. Chaplaincy service is primarily reserved for dying patients and their family members rather than providing proactive spiritual support. These observations highlight the need to better understand challenges and barriers to optimal chaplain involvement in ICU patient care. PMID:26025278

  18. Survival of AIDS patients and characteristics of those who died over eight years of highly active antiretroviral therapy, at a referral center in northeast Brazil

    Directory of Open Access Journals (Sweden)

    Ladjane Santos Wolmer de Melo

    2008-08-01

    Full Text Available Introduction of highly active antiretroviral therapy has resulted in a significant reduction in morbimortality and significant changes in the causes of death among HIV/AIDS patients. For this reason, it has become essential to monitor survival and causes of death. We constructed a survival curve based on 597 adult patients notified as AIDS cases between 1997 and 2004, at the Hospital das Clínicas, Federal University of Pernambuco, Recife, Brazil. Among those patients, 150 (25% progressed to death by December, 2005. Of these, 119 were studied in detail. The data were collected from notification files of the State Health Department and the State Mortality Information System, and were complemented by analysis of medical records. These 597 patients had a survival rate of 88%, 86% and 82% after one, two and five years, respectively, and a 75% likelihood of surviving to 1,984 days (66 months. Most of the deaths occurred during the first months after the diagnosis (median, 129 days. Patients who died were predominantly young men who had sexual exposure and came from Recife (the state capital or its metropolitan region. When the patients were first seen, a large proportion had already presented severe signs of immunodeficiency. Comparing the patients within this group, the characteristics that were associated with lower survival were: male sex, hemoglobin < 10 mg/dL, lymphocytes < 1,000/mm³, use of fewer therapeutic drugs and antiretroviral regimens and non-introduction of protease inhibitors. Most of them died from AIDS-related diseases, particularly undefined respiratory infections.

  19. DIE HEDENDAAGSE SIENING VAN DIE NORMERING VAN DUITS ...

    African Journals Online (AJOL)

    norm aan die een kant en deur die S^^eeksnorm aan die ander." (ibid. 384). ...... grondslag, hoewel die groot aantal voorbeelde uit die werke van Thomas Mann ...... Mentrup, W., & P. Kuhn, (1980) "Deutsche Sprache in Osterreich und in der.

  20. A population based study on variations in the use of adjuvant radiotherapy in breast cancer patients; Bevoelkerungsbezogene Studie ueber die Anwendung adjuvanter Strahlentherapie bei Patientinnen mit Mammakarzinom

    Energy Technology Data Exchange (ETDEWEB)

    Nagel, G.; Katenkamp, D. [Feldstudie Mammakarzinom/Tumorzentrum, Univ. Jena (Germany); Roehrig, B.; Hoyer, H. [Institut fuer Medizinische Statistik, Informatik und Dokumentation, Univ. Jena (Germany); Fueller, J. [Klinik fuer Radiologie, Abteilung fuer Strahlentherapie, Friedrich-Schiller-Universitaet, Jena (Germany)

    2002-11-01

    Aim: The assessment of the compliance with consensus recommendations for adjuvant radiation therapy among women with breast cancer. The study is based on data obtained in a population-based cohort-study, which was performed to evaluate the quality of health care for patients with breast cancer. Patients and Methods: About one million inhabitants live in the study region Eastern Thuringia. 2,031 cases with invasive breast cancer without distant metastasis (MO) or inflammatory spread were registered from 1995 to 2000. Out of these 1,700 with complete documentation of covariates were included in multivariate analysis. To examine the simultaneous influence of all clinical factors and 'caseload' on the likelihood to receive adjuvant radiation therapy a logistic regression model was fitted for radiation therapy after mastectomy. In order to describe the impact of each individual clinic on treatment decision as 'caseload' was replaced by the clinics with more than 30 primary treatments. Results: Following breast conserving therapy (BCT) 90.6% of the patients received adjuvant radiation therapy. In the univariate analysis older age was negatively associated with the use of radiation therapy among women with BCT (Table 1). Furthermore, comorbid conditions were negatively associated with the use of radiation therapy. For all other cofactors no associations were found. Subsequent to mastectomy 33.0% of the women underwent radiation therapy (Table 2). Associations between the use of radiation therapy and age, tumor category, number of positive lymph nodes, multiple tumors, histologic differentiation grade, residual tumor as well as hormone receptor status were found. In the multivariate analysis only older age ({>=}70 years) was identified as negative indicator for the utilization of radiation therapy. Among patients with mastectomy increasing tumor size was a positive predictor on radiation therapy (Table 3). In addition more than three positive lymph

  1. Die etiek van Luther

    Directory of Open Access Journals (Sweden)

    J. H. van Wyk

    1983-06-01

    Full Text Available Dink ons aan die etiek van Luther dan spring onmiddellik ’n paar boeiende uitsprake van hom na vore soos o.a. dat Christene vanuit die gemeenskap met Christus nuwe dekaloë moet maak wat helderder as die van Moses kan wees, of dat ons in bepaalde sin vir ons naaste ’n Christus moet word. Die bydrae van Luther 'tot die Christelike etiek is sonder twyfel van groot betekenis en die bestudering daarvan die moeite werd. Luther is geprys as rewolusionêr en verguis as konserwatis, hy is geëer as iemand wat weer die ware be­tekenis van godsdiens ontdek het toe die lewe vervloei het in etiek. Of dit egter korrek is om sy etiek as konserwatief te tipeer, soos White doen, moet betwyfel word.

  2. Comparative analysis of twelve Dothideomycete plant pathogens

    Energy Technology Data Exchange (ETDEWEB)

    Ohm, Robin; Aerts, Andrea; Salamov, Asaf; Goodwin, Stephen B.; Grigoriev, Igor

    2011-03-11

    The Dothideomycetes are one of the largest and most diverse groups of fungi. Many are plant pathogens and pose a serious threat to agricultural crops grown for biofuel, food or feed. Most Dothideomycetes have only a single host and related Dothideomycete species can have very diverse host plants. Twelve Dothideomycete genomes have currently been sequenced by the Joint Genome Institute and other sequencing centers. They can be accessed via Mycocosm which has tools for comparative analysis

  3. Ambrosius en die virginitas

    Directory of Open Access Journals (Sweden)

    C. J. Malan

    1985-05-01

    Full Text Available Ambrosius het met reg die benaming “Leraar van Maagdelikheid” ontvang (Dooley, 1948:119. Die opmerking van Thamin: “C’est une vertu proprement chrétienne que la vertu de virginité, proclame tout d’abord saint Ambroise” (1895:344, gee dadelik aanleiding tot die vraag of Ambrosius dan geen waardering vir die huwelik gehad het nie. Hierdie vraag word nog meer dringend as sy beskrywing van die kruis van die getroude lewe nagegaan word.

  4. Student Nurses' Perception of Death and Dying

    Science.gov (United States)

    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…

  5. Navorsing op die gebied van die sosiale wetenskappe*

    Directory of Open Access Journals (Sweden)

    P. M. Robbertse

    1958-03-01

    Full Text Available In Hollands is die woord scientia vertaal met wetenskap, wat sowel die natuur- as die geesteswetenskappe insluit, waardeur die woordsy oorspronklike betekenis behou. Die neiging bestaan om die Engels science met wetenskap in Afrikaans te vertaal, waarmee dan eintlik die natuurwetenskap bedoel word.

  6. Foute in die meting van die aarde se magneetveld met die protonmagnetometer

    Directory of Open Access Journals (Sweden)

    G. P. Hancke

    1989-03-01

    Full Text Available Die tipiese foute wat voorkom wanneer die metode van periode-meting gebruik word vir die bepaling van die presessiefrekwensie van die magnetiese moment van protone, word bespreek, en metodes om dit teen te werk word voorgestel. Belangrike gevolgtrekkings wat sal lei tot die optimale funksionering van die periodemeter, word gemaak — veral ten opsigte van die meettyd, polarisasietyd en die eienskappe van die sensorvloeistof.

  7. Wake up and Die

    DEFF Research Database (Denmark)

    Schubart, Rikke

    2013-01-01

    Anmeldelse af den colombianske gyserfilm Volver a morir (eng. titel Wake Up and Die) af Miguel Urrutia......Anmeldelse af den colombianske gyserfilm Volver a morir (eng. titel Wake Up and Die) af Miguel Urrutia...

  8. Die radio in Afrika

    Directory of Open Access Journals (Sweden)

    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.

  9. Die verhouding doop en geloof

    Directory of Open Access Journals (Sweden)

    L. Floor

    1983-06-01

    Full Text Available By die aanvalle wat op die kinderdoop geloods word, kom telkens die verhouding doop en geloof ter sprake. Die geloof is so wesentlik met die doop verbonde, sodat daar nie gedoop mag word waar die geloof nie aanwesig is nie. 0ns lees inderdaad dwarsdeur die Nuwe Testament van ’n innige samehang wat daar tussen geloof en doop beslaan.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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

    1979-06-01

    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.

  12. Twelve tips for peer observation of teaching.

    Science.gov (United States)

    Siddiqui, Zarrin Seema; Jonas-Dwyer, Diana; Carr, Sandra E

    2007-05-01

    This paper outlines twelve tips for undertaking peer observation of teaching in medical education, using the peer review model and the experiences of the authors. An accurate understanding of teaching effectiveness is required by individuals, medical schools, and universities to evaluate the learning environment and to substantiate academic and institutional performance. Peer Observation of Teaching is one tool that provides rich, qualitative evidence for teachers, quite different from closed-ended student evaluations. When Peer Observation of Teaching is incorporated into university practice and culture, and is conducted in a mutually respectful and supportive way, it has the potential to facilitate reflective change and growth for teachers.

  13. Die lebensvision des semonides

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    Milivoj Sironić

    1980-12-01

    Full Text Available Der Autor analysiert die Weibersatire des Semonides und andere seiner kurzen Fragmente. Dabei kommt er zu der Schlussfolgerung, dass sich die Verse der Satire durch eine gute Technik auszeich­ nen, dass aber auch eine unnötige Weitschweifigkeit nicht zu Ubersehen ist. Trotzdem kann man jedoch dem Dichter nicht die künstlerische Überzeugungskraft absprechen, wie auch die Ten­ denz nach Detailschilderungen und die Feinheit geistreicher Charakterisierungen. Die Aussage beinhaltet manchmal eine be­ stimmte innere Ironie in der Einfachheit der Wörter.In kurzen Fragmenten wird die Fähigkeit des Semonides sichtbar, sich sehr präzise auszudrücken. Seine ironisch-epische Sprache ist sehr reich  und verdient vom linguistischen Standpunkt aus Auf­ merksamkeit wegen ihres reichhaltigen lexischen und termino­ logischen Materials, insbesondere was die Bereiche der Tier­ welt und des Essens anbelangt.Die Weltanschauung des Dichters ist in dem ersten Fragment recht deutlich erkennbar. Da sieht man, dass er düster und pessimistisch auf das Leben blickt. Das Fehlen jeglicher positiven Einstellung hat dann den Sar­ kasmus zur Folge, mit dem der Dichter die Darstellung der Weiber einkleidet, ihn aber auch auf die Menschen schlechthin ausweitet.

  14. 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.

  15. Integrated medical-psychiatric care of a dying borderline patient: a case of dynamically informed "practical psychotherapy".

    Science.gov (United States)

    Lacy, Timothy J; Higgins, Michael J

    2005-01-01

    Combined training in family practice and psychiatry is relatively new and consists of equal proportions of each specialty intermixed throughout a 5-year period. This blending of two distinct skill sets and patient populations creates opportunities to provide unique patient care. An understanding of psychodynamic principles is vital to treating patients with comorbid medical and psychiatric illnesses in a primary care setting. The patient presented in this article had several medical and psychiatric problems and was treated by a combined family practice-psychiatry resident who cared for her medically and psychiatrically until the time of her death from cancer. Complex patients such as this defy the use of purely applied school-specific psychotherapies. Rather, they require the creative application of integrated psychotherapeutic strategies. Integrated approaches to psychotherapy have been increasingly advocated in recent years. In keeping with terminology used by Carl Jung, this approach may be thought of simply as practical psychotherapy.

  16. Die karst-ekologie van die Bakwenagrot (Gauteng

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    François Durand

    2012-03-01

    Full Text Available Die Bakwenagrot huisves ’n verskeidenheid organismes wat ’n ingewikkelde en verweefde voedselweb vorm. ’n Kolonie Natalse langvingervlermuise gebruik hierdie grot regdeur die jaar as blyplek. Die vlermuisguano en dooie plantmateriaal wat van buite in die grot inval, vorm die basis van die ekologie in die grot wat ook as ’n tipiese detritus-gedrewe ekostelsel beskryf kan word. Afbrekers soos bakterieë en swamme wat vir die afbraak van die guano en plantreste verantwoordelik is, word deur ’n verskeidenheid organismes, insluitend nematode en myte, as voedselbron benut. Hierdie organismes wat die volgende trofiese vlak vorm, word deur predatoriese artropode as voedselbron benut. Die Bakwenagrot is een van die weinige dolomietiese grotte in Suid-Afrika wat dit vir ‘n mens moontlik maak om tot by die grondwatervlak te kom. Die grondwater huisves verskeie tipes organismes waaronder bakterieë, swamme en diere – hoofsaaklik nematode en krustaseë. Die Bakwenagrot is ook die hoofvindplek waar varswater-amfipode in Suider-Afrika gevind is. Hierdie besondere en sensitiewe ekostelsel is hoofsaaklik van guano van die vlermuiskolonie afhanklik. Die grasveld in die gebied rondom die grot, wat as voedingsarea vir die vlermuiskolonie dien, word tans deur voorstedelike ontwikkeling en die gevolglike habitatfragmentasie en -vernietiging bedreig. Indien die vlermuise die grot sou verlaat, sal dit ’n hele domino-effek van uitsterwing van die grotbewonende organismes tot gevolg hê.

  17. Die voorgeskiedenis van kwantumberekening

    Directory of Open Access Journals (Sweden)

    P. H. Potgieter

    2004-09-01

    Full Text Available

    Die hoofidees wat tans gestalte vind in die teorie en tegnologie van kwantumberekening is in die laat 1970’s en vroeg 1980’s deur fisici in die Weste en ’n wiskundige in die voormalige Sowjetunie neergelˆ e. Dat di´ e teorie ook wortels in die Russiestalige vakliteratuur het, is nie algemeen bekend in die Weste nie. Daar word kortliks gekyk na die idee soos deur Benioff en (veral Feynman in die Weste versprei, asook die voorstel van di´ e rekengrondslag deur Manin in die Russiese literatuur. Die outeur hoop om hiermee so ’n onpartydig moontlike sintese van die vroe ¨ e gedagtegeskiedenis rondom kwantumberekening aan te bied. Die rol van omkeerbare en onomkeerbare berekeningsprosesse word vlugtig bekyk soos dit verband hou met die ontstaan van kwantumberekening, asook die sogenaamde Inligtingsparadoks in die fisika. Die inligtingsteorie en die fisika het heelwat met mekaar te kommunikeer, soos hierdie paradoks uitwys.

    Abstract

    The pre-history of quantum computation

    The main ideas behind developments in the theory and technology of quantum computation were formulated in the late 1970s and early 1980s by two physicists in the West and a mathematician in the former Soviet Union. It is not generally known in the West that the subject has roots in the Russian technical literature. The idea, as propagated by Benioff and (especially Feynman, is reviewed along with the proposition of a foundation for this kind of computation by Manin in the Russian literature. The author hopes to present as impartial a synthesis as possible of the early history of thought on this subject. The role of reversible and irreversible computational processes will be examined briefly as it relates to the origins of quantum computing and the so-called Information Paradox in physics. Information theory and physics, as this paradox shows, have much to communicate to each other.

  18. Die benutting van water in die landbou: strategie vir die toekoms

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    D. S. van der Merwe

    1985-03-01

    Full Text Available ’n Uiteensetting word gegee van die faktore wat die hoofrol in die toekomstige waterbenutting in die landbou gaan speel. Hierdie faktore is die hoeveelheid water beskikbaar vir landboudoeleindes; die toenemende mineraiisasie van besproeiingswater; en die invloed wat energiebehoeftes op besproeiing sal hê. Navorsing is nodig om die situasie na wense te hanteer, en die aanbevelings van besproeiingsnavorsingswerksessies in hierdie verband word kortliks aangedui en bespreek.

  19. Treating palliative care patients with pain with the body tambura: A prospective case study at St. Joseph′s hospice for dying destitute in Dindigul South India

    Directory of Open Access Journals (Sweden)

    Cordula Dietrich

    2015-01-01

    Full Text Available Background: The Body Tambura is a recently invented stringed instrument that is used for receptive music therapy designed to be placed and attached on the human body. The aim of this study was to record perceived effects of a treatment with the Body Tambura on palliative care patients with special reference to pain. Materials and Methods: A prospective case study was carried out with patients of St. Joseph′s Hospice for Dying Destitute in Dindigul/South India. Patients were treated with a treatment after baseline assessment and also on the next day. Outcomes were measured quantitatively by using a numeric rating scale (0-10, 10 maximum intensity of pain felt at baseline, directly after treatment, and the day after the treatment to determine the intensity of the pain. Results: Ten patients (five women and five men participated in the study. The majority described the therapy as a pleasant experience. The pain intensity at baseline was reduced from 8.3 ± standard deviation (SD 1.16 to 4.6 ± 1.52 at day 1 and from 4.6 ± 2.07 to 2.4 ± 1.58 at day 2. Conclusion: A clinically relevant pain reduction was described as short time outcome; the therapy was received and perceived well. Forthcoming research should include a control group, randomization, a larger number of participants, and a longer period of treatment.

  20. Openbaring, teologie en die regswetenskap

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    S. Postma

    1970-03-01

    Full Text Available In die jongste tyd is telkens en weer gewaarsku teen die gevare van oorspesialisasie en die hipertrofie van professionalisme. Die gemis aan ’n totaliteitsvisie wat hiermee gepaard gaan, word dan ook tereg teengegaan en wel deur aan die Wysbegeerte as die Wetenskap van die totaliteit van die kosmos in toenemende mate sy regmatige plek as wetenskapsintegreerder te gun. Hierdie grootmoedige gun van ’n plek in die son van geleerdheid kan egter ook uit bedenklike motiewe plaasvind. Die vakwetenskaplike kan nie of wil nie die plek en betekenis van sy spesifieke vak bepaal en bepeins nie en vind dit in elk geval moeilik om die verband tussen Gods Woord en sy besondere vak in duidelike perspektief te sien; vandaar dan ’n grootmoedige toelaat dat die wysbegeerte die „veritas” dien terwyl die eie ek tevrede is om die „utilitas” onderdanig te wees.

  1. Die tug oor ampsdraers tydens die doleansie van 1886

    Directory of Open Access Journals (Sweden)

    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.

  2. The compassion of concealment: silence between older caregivers and dying patients in the AIDS era, northwest Tanzania

    NARCIS (Netherlands)

    de Klerk, J.

    2012-01-01

    In northwest Tanzania, where AIDS has been present for 25 years, AIDS-related illness is a trigger through which community members discuss personal experiences of loss and assess social relationships. The terminal phase of AIDS demands intimate social relations between patients and caretakers. In th

  3. The situation of radiation oncology patients' relatives. A stocktaking; Die Situation der Angehoerigen von Strahlentherapiepatienten. Eine Bestandsaufnahme

    Energy Technology Data Exchange (ETDEWEB)

    Momm, Felix; Lingg, Sabine; Adebahr, Sonja; Grosu, Anca-Ligia [Klinik fuer Strahlenheilkunde, Univ. Freiburg (Germany); Xander, Carola; Becker, Gerhild [Palliativeinheit, Univ. Freiburg (Germany)

    2010-06-15

    Background and Purpose: Recent studies have shown a very high importance of relatives in decisions about medical interventions. Therefore, the situation of this group was investigated in the sense of a stocktaking by interviewing the closest relatives of radiotherapy patients. Interviewed Persons and Methods: In a defined span of time (6 weeks), a total of 470 relatives (evaluable: n = 287, 61%) of radiotherapy patients were interviewed by a newly developed questionnaire about their contentment with their inclusion in the therapy course. Further, they gave information about specific needs of relatives as well as proposals for direct improvements in the context of a radiation therapy. Results: In total, the relatives were satisfied with their inclusion in the radiotherapy course and with the patient care. As an example, more than 95% of the relatives agreed with the statement ''Here in the hospital my ill relative is cared for well.'' Nevertheless, direct possibilities for improvements were found in the interdisciplinary information about oncologic topics and in the organization of the therapy course. Conclusion: In the stocktaking the situation of radiotherapy patients' relatives was generally satisfactory. Further improvements for the future can be expected mainly from interdisciplinary cancer centers having the best suppositions to care for the relatives, if necessary. Structures known from palliative care can be used as a model. (orig.)

  4. Combining ability of twelve maize populations

    Directory of Open Access Journals (Sweden)

    Vacaro Elton

    2002-01-01

    Full Text Available Genetic progress depends on germplasm quality and breeding methods. Twelve maize populations and their crosses were evaluated to estimate combining ability and potential to be included as source populations in breeding programs. Plant height, point of insertion of the first ear, number of ears per plant, number of grains per ear, root and stalk lodging and grain yield were studied in two locations in Brazil, during the 1997/98 season. Genotype sum of squares was divided into general (GCA and specific (SCA combining ability. Results indicated the existence of genetic divergence for all traits analyzed, where additive effects were predominant. The high heterosis levels observed, mainly in Xanxerê, suggested the environmental influence on the manifestation of this genetic phenomenon. Populations revealed potential to be used in breeding programs; however, those more intensively submitted to selection could provide larger genetic progress, showing the importance of population improvement for the increment of the heterosis in maize.

  5. 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.

  6. Ontsporing van die regstaatsbegrip en sy konsekwensies vir die afrikanervolk

    Directory of Open Access Journals (Sweden)

    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

  7. Analise van die Tswanaraaisel

    Directory of Open Access Journals (Sweden)

    S. A. Swanepoel

    1984-05-01

    Full Text Available ’n Strukturele, stilistiese en funksionele bcskrywing van die Twanaraaisel bring mee dat daar aan die volgende aspekte aandag gegee moet word: •\tWat is ’n raaisel en lioe word dit in Tswana genoem. •\tTot watter studiegebied en literere genre hoort die raaisel en watter subvorme kan vir Tswana onderskei word. •\tHoe sien die struktuur van Tswanaraaisels daar uit. •\tDeur wie, waar, wanneer en hoe word Tswanaraaisels voorgedra. •\tWatter stilistiese kenmcrke kan in Tswanaraaisels onderskei word. •\tWatter funksies vervul raaisels in ’n Tswanagcmeenskap.

  8. Die brein soos beskou deur die Grieke en Romeine

    Directory of Open Access Journals (Sweden)

    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.

  9. A special radiation shielding for the radiotherapy of a pregnant patient; Eine Spezialabschirmung fuer die Strahlentherapie von Schwangeren

    Energy Technology Data Exchange (ETDEWEB)

    Buchgeister, M.; Mondry, A. [Bereich Medizinische Physik, Universitaetsklinik fuer Radioonkologie, Tuebingen (Germany); Spillner, P.; Paulsen, F.; Belka, C.; Bamberg, M. [Strahlentherapie, Universitaetsklinik fuer Radioonkologie, Tuebingen (Germany)

    2008-02-15

    Purpose: measurement of the radiation dose of different radiotherapy techniques with a phantom at the position of the uterus of a pregnant patient with and without a special radiation shielding. Material and methods: a special radiation shielding for the radiation therapy of a pregnant patient was constructed in the shape of a tunnel over the abdomen from 1 cm thick lead to reduce scatter radiation to the uterus and the fetus therein. The reduction of the scatter radiation to the lower abdomen was measured for three typical cases (cerebrum with lateral opposed fields, 6-MV photons; tangential fields for mamma irradiation, 6 MV; and anteroposterior-posteroanterior [AP-PA] opposed fields of 15 MV for treatment of the mediastinum) at an anthropomorphic Alderson phantom with thermoluminescence dosimeters in different depths and with an ionization chamber positioned in an RW3 solid water phantom. In the case of lateral opposed fields, a movable lead wall was additionally positioned next to the accelerator's head to reduce the scatter radiation from this source. Results: depending on the geometry of the radiation fields and on the photon energy, a reduction of the dose to the lower abdomen averaged over the depths of 6, 9, and 12 cm from 16% (15 MV, mediastinum case) to 51% (6 MV, cerebrum with additional lead wall) was achieved. The absolute scattered dose with shielding in place for a 2-Gy fraction dose results to 3.85 mGy and 0.27 mGy, respectively. Conclusion: national and international recommendations on the radiation dose to a fetus of a pregnant patient state limits of 200 mSv (DGMP report no. 7) and 100 mGy (ICRP 84), below which an abortion should not be considered and above which an indication for termination of the pregnancy could be given, respectively. The dose to the fetus can be kept below these limits with the shielding described in this work. Therefore, a radiation therapy of a pregnant patient is possible when these special precautions to reduce

  10. Prediking oor die poëtiese stof van die Ou Testament - Die Psalms

    Directory of Open Access Journals (Sweden)

    E. J. Smit

    1989-06-01

    Full Text Available ’n Belangrike rede waarom die prediking uit die Psalms ’n aparte bespreking regverdig, is die feit dat die Psalms die omvangrykste verteenwoordiging van poetiese stof in die Ou Testament be vat. Dit is nie vir almal ewe maklik om poesie te lees en te verklaar nie.

  11. Die Soldering in Aluminium Die Casting

    Energy Technology Data Exchange (ETDEWEB)

    Han, Q.; Kenik, E.A.; Viswanathan, S.

    2000-03-15

    Two types of tests, dipping tests and dip-coating tests were carried out on small steel cylinders using pure aluminum and 380 alloy to investigate the mechanism of die soldering during aluminum die casting. Optical and scanning electron microscopy were used to study the morphology and composition of the phases formed during soldering. A soldering mechanism is postulated based on experimental observations. A soldering critical temperature is postulated at which iron begins to react with aluminum to form an aluminum-rich liquid phase and solid intermetallic compounds. When the temperature at the die surface is higher than this critical temperature, the aluminum-rich phase is liquid and joins the die with the casting during the subsequent solidification. The paper discusses the mechanism of soldering for the case of pure aluminum and 380 alloy casting in a steel mold, the factors that promote soldering, and the strength of the bond formed when soldering occurs. conditions, an aluminum-rich soldering layer may also form over the intermetallic layer. Although a significant amount of research has been conducted on the nature of these intermetallics, little is known about the conditions under which soldering occurs.

  12. Die hebsugtige seekoei en Rooikappie: Die groteske in sprokies

    Directory of Open Access Journals (Sweden)

    Dineke van der Walt

    2012-11-01

    Full Text Available Hierdie artikel bied ’n vergelykende lees van twee volksverhale wat ook as kinderverhale getipeer kan word (een vanuit Venda-folklore en die ander ’n populêre Europese narratief met die oog daarop om spesifieke ooreenkomste uit te lig – soos die eet van mensvleis, goedgelowige mense wat deur ‘n maskerspel om die bos gelei word en ander ‘onetiese’ en ‘immorele’ aktiwiteite. In Die hebsugtige seekoei boots die monster byvoorbeeld die stem van die jong seun na om sy suster te flous en toegang tot hulle hut te verkry, terwyl die wolf in Rooikappie op sy beurt die ouma flous om die huis te kan betree sodat hy later ook vir Rooikappie kan mislei. In albei stories word die jong meisies (asook Rooikappie se ouma deur ’n seekoei óf ’n wolf opgeëet. Soos gewoonlik in sprokies, word die slagoffers gered of ontsnap en die verhale het ’n gelukkige einde. Alhoewel dit absurd mag voorkom dat kinderverhale elemente van die groteske bevat, argumenteer ek dat dit inderdaad ’n bruikbare doel dien. Hierdie verhale betrek kinders nie net op ’n emosionele vlak nie (as gevolg van die skokwaarde van die groteske; die groteske dien ook as objek van fassinasie. Sodoende word die waarskuwingsboodskap in die verhale beter oorgedra en onthou deur die kinders.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Die Gattung Oerstedia

    NARCIS (Netherlands)

    Stiasny-Wijnhoff, G.

    1930-01-01

    Die vorliegenden Individuen von Oerstedia dorsalis (Abildg.) wurden in den Helder an der holländischen Küste gesammelt; die Art war in frühern Jahren im Hafen sehr allgemein. Sie lebte zwischen Tubularien und Muschelbrut, welche in der Gezeitenzone den Schiffsrümpfen angewachsen sind und enthielt im

  15. Die Mollusken der Njalindungschichten

    NARCIS (Netherlands)

    Martin, K.

    1909-01-01

    Die Versteinerungen, welche im folgenden behandelt sind, sammelten meine Frau und ich im Jahre 1910 in den Preanger-Regentschappen von Java, in der Gegend von Njalindung ¹). Sie stammen aus Sedimenten, für welche ich den Namen Njalindungschichten einführte, und für die Gastropoden wurde bereits eine

  16. Twelve tips for getting your manuscript published.

    Science.gov (United States)

    Cook, David A

    2016-01-01

    The author shares twelve practical tips on how to navigate the process of getting a manuscript published. These tips, which apply to all fields of academic writing, advise that during the initial preparation phase authors should: (1) plan early to get it out the door; (2) address authorship and writing group expectations up front; (3) maintain control of the writing; (4) ensure complete reporting; (5) use electronic reference management software; (6) polish carefully before they submit; (7) select the right journal; and (8) follow journal instructions precisely. Rejection after the first submission is likely, and when this occurs authors should (9) get it back out the door quickly, but first (10) take seriously all reviewer and editor suggestions. Finally, when the invitation comes to revise and resubmit, authors should (11) respond carefully to every reviewer suggestion, even if they disagree, and (12) get input from others as they revise. The author also shares detailed suggestions on the creation of effective tables and figures, and on how to respond to reviewer critiques.

  17. Antifouling activity of twelve demosponges from Brazil

    Directory of Open Access Journals (Sweden)

    SM. Ribeiro

    Full Text Available Benthic marine organisms are constantly exposed to fouling, which is harmful to most host species. Thus, the production of secondary metabolites containing antifouling properties is an important ecological advantage for sessile organisms and may also provide leading compounds for the development of antifouling paints. High antifouling potential of sponges has been demonstrated in the Indian and Pacific oceans and in the Caribbean and Mediterranean seas. Brazilian sponges remain understudied concerning antifouling activities. Only two scientific articles reported this activity in sponges of Brazil. The objective of this study was to test crude extracts of twelve species of sponges from Brazil against the attachment of the mussel Perna perna through laboratorial assays, and highlight promising species for future studies. The species Petromica citrina, Amphimedon viridis, Desmapsamma anchorata, Chondrosia sp., Polymastia janeirensis, Tedania ignis, Aplysina fulva, Mycale angulosa, Hymeniacidon heliophila, Dysidea etheria, Tethya rubra, and Tethya maza were frozen and freeze-dried before extraction with acetone or dichloromethane. The crude extract of four species significantly inhibited the attachment of byssus: Tethya rubra (p = 0.0009, Tethya maza (p = 0.0039, Petromica citrina (p = 0.0277, and Hymeniacidon heliophila (p = 0.00003. These species, specially, should be the target of future studies to detail the substances involved in the ability antifouling well as to define its amplitude of action.

  18. Twelve Elastic Constants of Betula platyphylla Suk.

    Institute of Scientific and Technical Information of China (English)

    Wang Liyu; Lu Zhenyou

    2004-01-01

    Wood elastic constants are needed to describe the elastic behaviors of wood and be taken as an important design parameter for wood-based composite materials and structural materials. This paper clarified the relationships between compliance coefficients and engineering elastic constants combined with orthotropic properties of wood, and twelve elastic constants of Betula platyphylla Suk. were measured by electrical strain gauges. Spreading the adhesive quantity cannot be excessive or too little when the strain flakes were glued. If excessive, the glue layer was too thick which would influence the strain flakes' performance, and if too little, glues plastered were not firm, which could not accurately transmit the strain. Wood as an orthotropic material, its modulus of elasticity and poisson's ratios are related by two formulas:μij /Ei =μji /Ej and μij 0.95) between the reciprocal of elastic modulus MOE-1 and the square of the ratio of depth to length (h/l)2, which indicate that shear modulus values measured were reliable by three point bending experiment.

  19. Die oorsake vir die ontstaan en besondere aard van die Zion Christian Church

    Directory of Open Access Journals (Sweden)

    M. A. Kruger

    1972-06-01

    Full Text Available Aanvanklik het die Z.C.C. geen opsienbarende groei getoon nie, maar veral sedert die veertigerjare het hulle getalle skerp toegeneem en versprei oor die hele land. In 1963 is Edward Lekganyane toegelaat tot die Stofberg Teologiese Skool van die N.G. Kerk. Sedert die stigting van die Z.C.C. het die groep al verder van die Woord af weg beweeg, maar met hierdie toetrede tot die skool het daar by Edward self ’n mate van verandering gekom.

  20. Twelve-week efficacy and safety study of mometasone furoate/formoterol 200/10 microg and 400/10 microg combination treatments in patients with persistent asthma previously receiving high-dose inhaled corticosteroids

    DEFF Research Database (Denmark)

    Weinstein, Steven F; Corren, Jonathan; Murphy, Kevin;

    2010-01-01

    A significant unmet medical need exists in patients with uncontrolled asthma. The purpose of this study was to evaluate the efficacy and safety of mometasone furoate/formoterol (MF/F) 400/10 microg versus MF 400 microg administered twice-daily (b.i.d.) via metered-dose inhaler in patients...

  1. Tweedetaalteorie vir die eerstetaalonderwyser

    Directory of Open Access Journals (Sweden)

    Ludolph Botha

    2013-02-01

    Full Text Available In hierdie artikel word die eerstetaalonderwyser se aandag op tweedetaalteorie gevestig. Krashen se tweedetaalteorie word uitgesonder en die implikasies van sy werk vir eerstetaalonderwysersword ondersoek. Die oordrewe beklemtoning van vormen struktuur in moedertaalklasse ( oor die taal praatl lees/ skryf word vanuit die gesigspunt van Krashen se taalverwerwingsteorie beskou en die gevolgtrekking word gemaak dat daar veel meer klem op gebruiksvaardigheid behoort te val (in die taal praat!lees!skryf. In this article the first language teacher is made aware of second language teaching theory. Particularly Krashen' s second language theory is referred to and implications of his work for mother tongue teachers are discussed. The over-emphasis on form and structure in first language classes (talking/reading/writing about the language is looked at in terms of Krashen' s theory and it is concluded that the emphasis in first language classes should be far more on the functional use of the language (talking/reading/writing in the language.

  2. Awareness of Dying Preface

    Directory of Open Access Journals (Sweden)

    Barney G. Glaser, PhD, Hon. PhD

    2015-12-01

    Full Text Available Recently The New York Times reported: “VERY ILL CHILDREN TOLD OF DISEASE; Leukemia Patients at N.I.H. Not Shielded From Truth. . . . A child should always be told the truth, even when he has an incurable disease such as leukemia, according to two researchers who interviewed 51 children hospitalized at the National Cancer Institute, Bethesda, Maryland, for treat¬ment of leukemia.” This kind of news item reflects the growing concern among researchers and public about matters which touch on morality as much as on the technical aspects of medi¬cine. The rapidly increasing proportion of elderly people in the American population presents a range of personal and social questions; not the least is how they view their newly won longevity (often including anticipated years of chronic disease as well as their attitudes toward death. In consequence, many geriatric specialists are beginning to study American attitudes toward death, while others, spurred on by what seems a sense-less prolonging of life within hospital walls by medical tech¬nology run wild, are raising questions about death and dying in American life.

  3. Die kairos van die New Age: 'n Kultuurhistoriese skets

    African Journals Online (AJOL)

    the whole universe, manifesting the two aspects of spirit and matter, .... vestiging van die Christendom het hierdie leer uit die Westerse kultuur verdwyn tot- ... Hegel (1770-1831) het die Simboliste aangespreek (Mathews 1986:30-31, 33). Sy.

  4. Oor die einders van die bladsy as konseptuele kuns

    Directory of Open Access Journals (Sweden)

    Rita M.C. Swanepoel

    2012-11-01

    Full Text Available Hierdie artikel bied ’n filosofies-besinnende oorsig oor konseptuele kuns. Ek argumenteer dat, soos wat die projek Oor die einders van die bladsy die grense van boekwees oorskry en konseptueel uitbrei, dit in geheel ’n konseptuele en taalgebaseerde kunsinstallasie is wat uit verskeie komponente, naamlik kunstenaarsboeke,bestaan. Hierdie saamgestelde konseptuele kunsinstallasie daag vanweë die interdissiplinêre aard daarvan, die grense van konseptuele kuns uit. Hierdie projek en uitstallings bevestig dat kunstenaarsboeke ’n ideale medium is om kunstenaars uit verskillende dissiplines by die spel met en ontdekking van die moontlikhede van die boek te betrek. Die projek kan in die geheel as konseptuele kuns getipeer word omdat die konsep boek herdink, herskep en oor gefilosofeer word.

  5. Die owerheidsinmenging met betrekking tot kerklike tughandelinge.

    Directory of Open Access Journals (Sweden)

    L. Roeleveld

    1982-06-01

    Full Text Available Volgens art 29 NGB is die merktekens van die ware kerk die suiwere prediking van die Evangelie, die suiwere bediening van die Sakramente en die gebruik van die kerklike tug. Art. 32 NGB spreek uit dat die Kerkorde nie mag afwyk van wat Christus ingestel het nie. Menslike vindinge en wette om die gewetens te bind en te dwing, moet daarom verwerp word. Die ekskommunikasie of die ban moet toegepas word volgens die Woord van God.

  6. Twelve weeks treatment with the DPP-4 inhibitor, sitagliptin, prevents degradation of peptide YY and improves glucose and non-glucose induced insulin secretion in patients with type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Aaboe, K; Knop, F K; Vilsbøll, T

    2010-01-01

    To examine the effects of 12 weeks of treatment with the DPP-4 inhibitor, sitagliptin, on gastrointestinal hormone responses to a standardized mixed meal and beta cell secretory capacity, measured as glucose and non-glucose induced insulin secretion during a hyperglycaemic clamp, in patients with...

  7. Letting die and mercy killing.

    Science.gov (United States)

    Narbekovas, Andrius; Meilius, Kazimieras

    2003-01-01

    We are all called to make moral decisions, not only about preserving life and health, but also about accepting our death and dying. There are situations, when it is morally right, and indeed obligatory, to allow a dying person to die in peace and dignity. But there is a world of difference between allowing a peaceful death, and deliberately setting out to bring death of the person either by acts of commission (s.c. 'active euthanasia'), or by acts of omission (s.c. 'passive euthanasia'). The word "killing" seems proper for euthanasia, because "to kill" does mean " to intentionally cause the death of someone." It can be morally acceptable to withhold or withdraw a treatment precisely because it is reasonably judged as inefficacious (futile), or excessively burdensome for the patient. One's reason for withholding such treatment must not be a judgement about the desirability of putting an end to the patient's life, but a judgement about the desirability of putting an end to the treatment, which is futile or burdensome.

  8. Die verband tussen die sielkundige kontrak en organisasieverbondenheid

    Directory of Open Access Journals (Sweden)

    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

  9. Die postpolitische Stadt

    Directory of Open Access Journals (Sweden)

    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. [...

  10. Die Anima in Eschenbachs Parzival

    OpenAIRE

    Kitunen, S. (Sakari)

    2014-01-01

    In meiner Pro-Gradu -Arbeit untersuche ich die Darstellung und Entwicklung des Jungschen Animabegriffes im Parzival von Wolfram von Eschenbach. Ich werde die in Parzival vorkommenden Charaktere als Anima- und Animus-Figuren analysieren und untersuchen, wie die Interaktion zwischen ihnen die Entwicklung des Helden beeinflusst. Viele Werke, die das Thema Frauen bzw. Weiblichkeit im Mittelalter behandeln, gehen oft davon aus, dass die Frauen in der mittelalterlichen Literatur als Objekte behande...

  11. Twelve-week efficacy and safety study of mometasone furoate/formoterol 200/10 microg and 400/10 microg combination treatments in patients with persistent asthma previously receiving high-dose inhaled corticosteroids

    DEFF Research Database (Denmark)

    Weinstein, Steven F; Corren, Jonathan; Murphy, Kevin

    2010-01-01

    with asthma uncontrolled on high-dose inhaled corticosteroids (ICS). In a 12-week, randomized, multicenter, double-blind, parallel-group study, patients (>or=12 years of age) were randomized to MF/F 200/10 microg, MF/F 400/10 microg, or MF 400 microg, b.i.d. after a 2- to 3-week open-label run in with MF 400...

  12. Die liefde wat die son beweeg en die ander sterre: Digterlike transendering – tot die vermenigvuldigde lewe ontroer

    Directory of Open Access Journals (Sweden)

    A.S. (Rensia Robinson

    2014-09-01

    Full Text Available T.T. Cloete se oeuvre word onder andere gekenmerk deur fyn waarneming van ’n mistieke vervlegtheid in die skepping. Dit word op vele maniere ontgin en geïnterpreteer. Die poëtiese potensiaal van die vrou, in uiteenlopende gestaltes, is een van die sentrale temas waardeur die digter hieraan vorm gee. In die kunstige, bibliofiele uitgawe Uit die wit lig van my land gesny val die lig op die vrou se kreatiewe rol in die groter skepping wat haar onder andere identifiseer as haarveer vir digterlike insig en vormgewing. Vrou (alternatief Anna Perenna, universele moeder, is nie slegs draer van die lewenskiem wat tot gees transendeer nie, maar sy funksioneer as ligbron (’sonvrou’ wat selfs kosmiese insig verwesenlik. Dit raak meervoudige vorms en patrone waarin die mens ingeweef is in die universele hologram van lewe. Vir die digter is hierdie patroonvorming vergelykbaar met die maak van Persiese tapyte waarvan die patrone vasgelê is in die geheue van voorouers, en oorgedra word na opeenvolgende geslagte. In dié verkenning word digterlike transendering ontgin as ’n proses waarin die kleurvolheid van lewe en dood in en deur individuele sowel as universele vroulikheid geïnspireer word.

  13. Die liefde wat die son beweeg en die ander sterre: Digterlike transendering – tot die vermenigvuldigde lewe ontroer

    Directory of Open Access Journals (Sweden)

    A.S. (Rensia Robinson

    2014-02-01

    Full Text Available T.T. Cloete se oeuvre word onder andere gekenmerk deur fyn waarneming van ’n mistieke vervlegtheid in die skepping. Dit word op vele maniere ontgin en geïnterpreteer. Die poëtiese potensiaal van die vrou, in uiteenlopende gestaltes, is een van die sentrale temas waardeur die digter hieraan vorm gee. In die kunstige, bibliofiele uitgawe Uit die wit lig van my land gesny val die lig op die vrou se kreatiewe rol in die groter skepping wat haar onder andere identifiseer as haarveer vir digterlike insig en vormgewing. Vrou (alternatief Anna Perenna, universele moeder, is nie slegs draer van die lewenskiem wat tot gees transendeer nie, maar sy funksioneer as ligbron (’sonvrou’ wat selfs kosmiese insig verwesenlik. Dit raak meervoudige vorms en patrone waarin die mens ingeweef is in die universele hologram van lewe. Vir die digter is hierdie patroonvorming vergelykbaar met die maak van Persiese tapyte waarvan die patrone vasgelê is in die geheue van voorouers, en oorgedra word na opeenvolgende geslagte. In dié verkenning word digterlike transendering ontgin as ’n proses waarin die kleurvolheid van lewe en dood in en deur individuele sowel as universele vroulikheid geïnspireer word.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Lymphoscintigraphy for non-invasive long-term follow-up of the functional outcome in patients with autologous lymph vessel transplantation; Lymphsequenzszintigraphie fuer die nichtinvasive Langzeitbeobachtung des funktionellen Therapieerfolges nach Transplantation autologer Lymphgefaesse

    Energy Technology Data Exchange (ETDEWEB)

    Weiss, M. [Klinikum Grosshadern, Klinik und Poliklinik fuer Nuklearmedizin, Muenchen Univ. (Germany); Baumeister, R.G.H. [Klinikum Grosshadern, Chirurgische Klinik, Abt. fuer Mikro-, Hand- und Rekonstruktionschirurgie, Muenchen Univ. (Germany); Tatsch, K. [Klinikum Grosshadern, Klinik und Poliklinik fuer Nuklearmedizin, Muenchen Univ. (Germany); Hahn, K. [Klinikum Grosshadern, Klinik und Poliklinik fuer Nuklearmedizin, Muenchen Univ. (Germany)

    1996-12-01

    The aim of the present study was to answer the question, whether scintigraphic long-term follow up and semiquantitative evaluation of lymphatic flow could prove the persisting success of this sophisticated microsurgical technique. In this study visual and semiquantitative lymphoscintigraphy was used to prove the function of lymphatic vessel grafts in 20 patients (17 females, 3 males) comparing a preoperative baseline study with postoperative follow up investigations for a period of 7 years. The reason for microsurgical lymph vessel transplantation was in 4 patients a primary and in 16 patients a secondary lymphedema. In 12 cases the transplantation site was at the upper extremity, in 8 cases at the lower limb. In 17/20 patients lymphatic function significantly improved after autologous lymph vessel transplantation compared to the preoperative findings, as verified by visual improvement of lymph drainage and decrease of a numeric transportindex. In 5 cases the vessel graft could be directly visualized. In these patients with scintigraphic visualization of the vessel graft the transportindex decreases to a significantly greater extent compared to the preoperative baseline study. Only 3 patients did not benefit from microsurgical treatment. Lymphoscintigraphy combined with semiquantitative estimation of lymphatic transport kinetics has shown to be an easy, reliable and readily available technique to assess lymphatic function before and after autologous lymph vessel transplantation. Thus, the method is not only helpful in planning microsurgical treatment but also in monitoring the postoperative improvement of lymph drainage. Patients with scintigraphic visualization of the vessel graft showed a significant better postoperative outcome than those without. The sicnitgraphic visualization of the vessel graft therefore seems to indicate a favourable prognosis regarding to lymph drainage. (orig./MG) [Deutsch] Die autologe Lymphgefaesstransplantation fuehrt bei bestehendem

  16. Diskussie oor die millenium en die herstel van Israel

    Directory of Open Access Journals (Sweden)

    J. J. Engelbrecht van Waverley

    1978-06-01

    Full Text Available Dit verheug my dat daar eindelik gereageer word op my boekie. Behalwe telefoonoproepe en briewe van medechiliaste was daar tot dusver geen kommentaar van anti-chiliastiese kant. Ek het die boekie aan ongeveer 1800 predikante en professore gestuur en vriendelik uitgenooi tot nuwe besinning. Net soos oor die soteriologie, is die Bybel nêrens in teëspraak met homself oor die eskatologie nie. God gee in sy Woord nie vir ons drie verskillende toekomsbeelde om uit te kies nie. God is een en sy profetiese Woord is deurgaans eenstemmig m.b.t. die raad van God oor Israel, die nasies en die kerk.

  17. Die kerk en die kommunisme, uitgangspunt en perspektief

    Directory of Open Access Journals (Sweden)

    A. H. Murray

    1970-06-01

    Full Text Available Waar ons onmiddellike opdrag is om die konkrete taak van die kerk in die bestryding van Kommunisme en Marxisme te beskrywe, is ons gedwing om terug te dink aan die eerste grondslae van die vyandelike aanslag — die grondslae waarop sy leer en sy beleid van gewelddadige optrede berus. Want ons het nie te doen met ’n opportunistiese onderneming of ’n imperialistiese waagstuk as dit oor die Kommunisme gaan nie, en ook nie met die blinde opbruising van laere en agterlike volksklasse nie, maar wel met ’n deurdagte en afgeronde heelal-filosofie wat oor die aardbol versprei is en wat op sistematiese wyse en met wetenskaplike strategie ’n aanval op die bestaande Christelike orde maak.

  18. Killing, letting die and euthanasia.

    Science.gov (United States)

    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.

  19. Clinical and genetic study of twelve Chinese patients with Alexander disease%亚历山大病12例中国患儿临床及遗传学研究

    Institute of Scientific and Technical Information of China (English)

    臧莉莉; 吴晔; 王静敏; 顾强; 姜玉武; 高志杰; 杨艳玲; 肖江喜; 吴希如

    2012-01-01

    Objective To delineate the phenotype and genotype characteristics in 12 Chinese children with Alexander disease ( AD),which is helpful for the molecular diagnosis and genetic counseling in China.Methods Clinical diagnosis of AD was based on MRI criteria proposed by van der Knaarp in 2001.Included AD patients were followed up for 0.50-3.67 years.Mutations in GFAP were detected by DNA sequencing.Results The 12 cases of AD were clinically diagnosed.Age of first visit was 4.87 years (0.75-12.00 years),with 3 type s of chief complaints:developmental delay in 3,recurrent seizures in 7,unable to walk after falling in 2.Average head circumference was 52.34 cm (44-58 cm),which larger than age-matched average by 6.45% ( 1.80% -13.95% ).On the first visit,scaling according to Gross motor functional classification system ( GMFCS ) was performed,with GMFCS Ⅰ in 8,Ⅱ in 3,V in 1.Mild to severe cognitive dysfunction were found in 8,and seizures in 11 cases.The 12 patients were followed up for 0.50-3.67 years,their motor and cognitive function remained stable. Episodic aggravations provoked by fever or falling were observed in 5 cases (41.67%). Heterozygous missense mutations of GFAP were detected in 12 patients.All mutations were de novo; 3 out of 10 mutations identified were novel.R79 and P239 were hot mutations,which was consistent with previous reports.Mutations were located in exon 1 in 8 cases.Conclusions The phenotype in these patients is characterized by slower progression compared with reports from other population and high incidence of seizures.And episodic aggravations provoked by fever or falling were more common.The genotype characteristics are consistent with previous reports.The results of this research expanded the number of patients with Alexander disease found to have GFAP coding mutations in China.%目的 了解12例中国亚历山大病(Alexander disease,AD)患儿的临床表型及遗传学特点,为在国内开展该病的分子诊断及

  20. Die Psychosen bei Epilepsie

    Directory of Open Access Journals (Sweden)

    Glauninger G

    2001-01-01

    Full Text Available In einer Übersicht werden die verschiedenen Formen psychotischer Zustandsbilder bei Epilepsiepatienten, deren Ätiopathogenese und Möglichkeiten der Behandlung dieser Störungen beschrieben. Risikofaktoren finden sich durch neurobiologische Gegebenheiten - besonders bei Mitbeteiligung des Temporallappens, durch psychosoziale Einflüsse und manchmal auch durch medikamentöse Behandlung. Anhand von Fallbeispielen sollen dem Leser typische Krankheitsverläufe von psychotischen Episoden bei Epilepsiepatienten, die zumeist erst bei einer schon länger dauernden Epilepsie auftreten, nähergebracht werden. Es wird deutlich, daß sich die Beschwerden von Patienten mit Epilepsie nicht auf iktale Phänomene beschränken. Bei der Behandlung dieser Patienten kommt einer guten interdisziplinären Zusammenarbeit besondere Bedeutung zu.

  1. Long-term prognosis in patients with severe late radiation enteropathy: A prospective cohort study

    Institute of Scientific and Technical Information of China (English)

    Annette Larsen; Jon B Reitan; Steinar T Aase; Martin Hauer-Jensen

    2007-01-01

    AIM: To assess persistent symptoms and mortality in a cohort of patients with severe (grade 3-4) radiation enteropathy, 59 patients were followed up after 15-18years.METHODS: Fifty-nine patients were prospectively enrolled by twelve surgical departments. Primary malignant disease, radiation therapy and surgical management were recorded at inclusion. The cause of death or persistence of symptoms was examined in public death records or by interview of survivors.therapy for gynaecological cancers, twelve for urological cancers, four for gastrointestinal cancers and four for other malignancies. Forty-five patients (76%) required surgical intervention. Complications occurred in 11 (25%)operated patients. Forty-seven patients had died at the time of follow-up, seven (12%) died as a direct result of radiation enteropathy, while radiation enteropathy contributed to death in an additional seven patients. Four of the twelve surviving patients suffered from chronic debilitating symptoms of radiation enteropathy, while three had moderate symptoms.CONCLUSION: Patients with severe delayed radiation enteropathy have a high risk of persistence of symptoms after surgery. At least one in ten patients dies from radiation-induced bowel injury.

  2. Wêreldgebeure gedurende die jaar 1954.

    Directory of Open Access Journals (Sweden)

    S. du Toit

    1954-03-01

    Full Text Available Die jaar 1954 het begin sonder Stalin, die magtigste diktator van die modeme tyd, en dit wa s nog onseker hoe die nuwe regime sou optree.Teen die einde van die ja a r weet ons nou dat hulle oënskynlik meer toeskietlik is maar in wese nog net so geheimsinnig en nog net so geslepe. Die Petrof-gesjriedenis in Australië het weereens laat blyk dat daar oordie hele aarde ’n netwerk van spioene is.

  3. Die voorspelling van akademiese prestasie na die eerste universiteitsjaar

    Directory of Open Access Journals (Sweden)

    G. K. Huysamen

    1998-06-01

    Full Text Available The prediction of academic performance after the first year at university. In agreement with findings elsewhere, the correlations of high school performance (Swedish Formula Point and the verbal and nonverbal GSAT scores with the mean percentage marks (MPMs gradually decreased from the first through sixth semester at university, whereas the decrease in the corresponding correlations with the cumulative mean percentage marks (CMPMs was less pronounced. The later the semester for which either an MPM or a CMPM was used as a predictor, the higher the latter tended to correlate with the MPMs of subsequent semesters but these correlations also decreased in size over the ensuing semesters. The best predictor of the MPM of any given semester was either the MPM of the immediately preceding semester or the CMPM of all the preceding semesters. Opsomming In ooreenstemming met bevindings elders, het die korrelasies van hoërskoolprestasie (Sweedse Formulepunt en verbale en nie-verbale ASAT-tellings met die gemiddelde persentasiepunte (GPP's geleidelik van die eerste tot die sesde semester op Universiteit afgeneem, terwyl die afname in die ooreenstemmende korrelasies met die kumulatiewe gemiddelde persentasiepunte (KGP's minder opvallend was. Hoe later die semester waarvan die GGP of KGP as voorspeller gebruik is, hoe hoër was dit geneig om met die GGP's van die daaropvolgende semesters te korreleer, maar die korrelasies het: eweneens met die toename in laasgenoemde semesters in grootte afgeneem. Die beste voorspeller van die GPP van enige gegewe semester was of die GPP van die pas afgelope semester, of die KGP van al die voorafgaande semesters.

  4. 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...

  5. Die Kunst des Scheiterns

    DEFF Research Database (Denmark)

    Juul, Jesper

    2014-01-01

    Menschen haben von Kindesbeinen an das Verlangen, Erfolge zu erzielen und Kompetenz zu erreichen. Computerspieler entscheiden sich jedoch fortlaufend für eine Aktivität, die oft und wiederholt zum Verlieren führen muss und ein taubes Gefühl der Unfähigkeit erzeugt. Im Kino, im Theatersaal und bei...

  6. Die skool en die onderwyser as faktore in die geestesgesondheid van die kind*

    Directory of Open Access Journals (Sweden)

    B. C. Schutte

    1961-03-01

    Full Text Available Ons hou geestesgesondheidsweke, stig beroepsentrums, samel geld in om mense wat geestelik siek is te genees, klae oor die tekort aan psigiaters, kliniese sielkundiges, bedryfsielkundiges, voorligters, skoolpsigoloë,ens. ’n Karige kwarteeu gelede het ons aan al hierdie dinge slegs akademiese aandag gewy. In hierdie kursus wordverskeie tipes kinders bespreek en geleer hoe om hulle probleme te benader.

  7. Die Kunst des Scheiterns

    DEFF Research Database (Denmark)

    Juul, Jesper

    2014-01-01

    Menschen haben von Kindesbeinen an das Verlangen, Erfolge zu erzielen und Kompetenz zu erreichen. Computerspieler entscheiden sich jedoch fortlaufend für eine Aktivität, die oft und wiederholt zum Verlieren führen muss und ein taubes Gefühl der Unfähigkeit erzeugt. Im Kino, im Theatersaal und bei...

  8. Die Creol Taal

    NARCIS (Netherlands)

    Rossem, van Cefas; Voort, van der Hein

    1996-01-01

    Negerhollands is the original creole language, lexically closely related to Dutch, of the Virgin Islands. It emerged as a separate language around 1700 and died out completely only a few years ago, having gradually been replaced by English in the course of the nineteenth century. Apart from giving i

  9. Die andere Revolution

    Science.gov (United States)

    Kippenhahn, Rudolf

    2005-05-01

    War Kopernikus der größte Revolutionär des naturwissenschaftlichen Weltbildes? Seine Erkenntnisse waren der Beginn eines jahrhundertelangen Denkprozesses, welcher zur Einsicht führte, dass im Weltall die gleichen physikalischen Gesetze gelten wie auf der Erde.

  10. Die Kosmologie der Griechen.

    Science.gov (United States)

    Mittelstraß, J.

    Contents: 1. Mythische Eier. 2. Thales-Welten. 3. "Alles ist voller Götter". 4. Griechische Astronomie. 5. "Rettung der Phänomene". 6. Aristotelische Kosmololgie. 7. Aristoteles-Welt und Platon-Welt. 8. Noch einmal: die Göttlichkeit der Welt. 9. Griechischer Idealismus.

  11. Die ontwikkeling van 'n instrument vir die meting van die konstruk sielkundige diepte-orientasie

    Directory of Open Access Journals (Sweden)

    L. C. De Jager

    1981-11-01

    Full Text Available The development of an instrument (the RD-Depth Questionnaire, Form B for measuring the construct psychological depth orientation is discussed. Results show that the questionnaire has satisfactory internal consistency and that the items of the questionnaire in general measure the same characteristic. Further research is needed to refine and improve the questionnaire until it meets all the psychometric requirements of a good measuring instrument.OpsommingDie ontwikkeling van 'n instrument (die RD-Diepte Vraelys, Vorm B vir die meting van die konstruk sielkundige diepteoriëntasie word bespreek. Resultate dui daarop dat die vraelys bevredigende interne bestendigheid toon en dat die items van die vraelys oor die algemeen dieselfde eienskap meet. Verdere navorsing word egter nog vereis om die vraelys te verfyn en te verbeter sodat dit aan al die psigometriese vereistes van 'n goeie meetinstrument sal voldoen.

  12. Improvement of die life in high speed injection die casting

    Institute of Scientific and Technical Information of China (English)

    Yasuhiro Arisuda; Akihito Hasuno; Junji Yoshida; Kazunari Tanii

    2008-01-01

    High-speed injection die casting is an efficient manufacturing technology for upgrading aluminum die-cast products. However, deficiencies (such as die damage in eady period) due to larger load on the molding die compared with conventional technology have brought new challenges. In this study, the cause of damage generated in super high-speed injection was investigated by the combination of experimental observation of the dies and CAE simulation (e.g. die temperature analysis, flow analysis and thermal stress analysis). The potential countermeasures to solve the above problems were also proposed.

  13. Improvement of die life in high speed injection die casting

    Directory of Open Access Journals (Sweden)

    Akihito Hasuno

    2008-11-01

    Full Text Available High-speed injection die casting is an effi cient manufacturing technology for upgrading aluminum die-cast products. However, defi ciencies (such as die damage in early period due to larger load on the molding die compared with conventional technology have brought new challenges. In this study, the cause of damage generated in super high-speed injection was investigated by the combination of experimental observation of the dies and CAE simulation (e.g. die emperature analysis, fl ow analysis and thermal stress analysis. The potential countermeasures to solve the above problems were also proposed.

  14. Die Wiege stand doch in Africka

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    Kaum ein Forschungsgebiet ist so umstritten wie die Palaeoanthropologie, die Lehre yore Ursprung der Menschheit. Nicht nur die Vorgeschichte, ouch die unmittelbare Entstebung des Homo sapiens entzweit die Experten: Die einen verrnuten die Wiege in Afrika,die anderen gehen davon aus, dass sich tier moderne Mensch auf mehreren Kontinenten gleichzeifig aus Vorfahren eatwickelte,

  15. The research of dying emotional experience of patients with advanced cancer%晚期癌症患者临终情感体验的研究

    Institute of Scientific and Technical Information of China (English)

    向克兰; 王青丽; 赵凤; 彭翠香; 吕晓玲

    2010-01-01

    目的 探索和理解晚期癌症患者面l临死亡时内心世界的情感体验,以及他们在治疗护理过程中的真实心理感受.方法 用立意取样法取13例晚期癌症患者,运用深入访谈法收集资料,用Colaizzi法对采集资料进行分析.结果 找出与本研究相关的3个主题:①疾病本身带来的痛苦感受:癌痛无法控制的感受;对治疗护理丧失信心、缺乏舒适的感受.②对死亡态度的体验与感受:对死亡恐惧的感受;对死亡迫近的感受;心理落差的感受;心理负担的感受;被迫接受的感受.③情感支持的需求:情感支持的感受;寻找一种解脱的方式.结论 应重视患者的主观感受,用爱心去倾听,以共情去感受;临终患者需要临终关怀和有效的情感支持;临终患者需要对癌痛及癌痛控制方法的认知.帮助其提高舒适度,适时进行死亡教育.%Objective To explore and understand patients with advanced cancer faced with the death of the inner worid of emotional experience,as well as their real psychological feelings in the process of the treatment and nursing Methods To use purposive sampling method from 13 cases of patients with advanced cancer,using in-depth interviews with data collection,and Colaizzi method of collecting data for analysis.Results To identify related to our three themes:①the pain caused by the disease itself:the feeling of pain can not control;loss of confidence on the curative care;lack of a comfortable feeling.②experience on attitudes toward death and feelings:the feelings of fear of death;the feeling of imminent death;mind the feelings of difference;mind the feelings of burden;forcing to accept the feelings.③emotional support demands:the feeling of emotional support;looking for a free way.Conclusions We should attach importance to the subjective feeling of love,uge love to listen,to feel empathy;dying patients need hospice and effective emotional support;and they need for pain and cancer pain

  16. Twelve tips for designing and running longitudinal integrated clerkships.

    Science.gov (United States)

    Ellaway, Rachel; Graves, Lisa; Berry, Sue; Myhre, Doug; Cummings, Beth-Ann; Konkin, Jill

    2013-12-01

    Longitudinal integrated clerkships (LICs) involve learners spending an extended time in a clinical setting (or a variety of interlinked clinical settings) where their clinical learning opportunities are interwoven through continuities of patient contact and care, continuities of assessment and supervision, and continuities of clinical and cultural learning. Our twelve tips are grounded in the lived experiences of designing, implementing, maintaining, and evaluating LICs, and in the extant literature on LICs. We consider: general issues (anticipated benefits and challenges associated with starting and running an LIC); logistical issues (how long each longitudinal experience should last, where it will take place, the number of learners who can be accommodated); and integration issues (how the LIC interfaces with the rest of the program, and the need for evaluation that aligns with the dynamics of the LIC model). Although this paper is primarily aimed at those who are considering setting up an LIC in their own institutions or who are already running an LIC we also offer our recommendations as a reflection on the broader dynamics of medical education and on the priorities and issues we all face in designing and running educational programs.

  17. Die Tambaniprojek: ’n rekenaaranimasie van Die hebsugtige seekoei

    Directory of Open Access Journals (Sweden)

    Rita M.C. Swanepoel

    2012-11-01

    Full Text Available Hierdie artikel bied ’n ondersoek na en refleksie op die tegnieke en die produksieprosesse wat gebruik is in die omskakeling van ’n tradisionele Ngano-Venda-volksverhaal, Die hebsugtige seekoei, vanaf borduurwerk in ’n digitale animasiefilm. Die artikel word gerig deur ’n metode wat afgelei is uit ’n praktykgebaseerde navorsingsmodel vir skeppende uitsette. Hierdie navorsingsmodel omskryf wyses waarvolgens skeppende uitsette as geldige navorsingsopsies gereken kan word. Die metode bestaan uit die dokumentering van en refleksie ten opsigte van die projek in drie fases, naamlik pre-produksie, produksie en post-produksie. Die Tambani-borduurwerkprojek is ’n gemeenskapsuitreikingsinisiatief wat deur Ina le Roux van stapel laat loop is. Ngano is die versamelwoord vir tradisionele Vendavolksverhale. In hierdie artikel argumenteer ons dat rekenaaranimasietegnieke wel suksesvol geïmplementeer word in die digitale omskakeling van ’n Venda-volksverhaal wat oorspronklik uit ’n mondelinge tradisie stam. Ons demonstreer hierdie argument aan die hand van Christiaan van der Westhuizen se omskakeling van Die hebsugtige seekoei in ’n rekenaaranimasie.

  18. 临终患者家属安宁疗护知识需求调查%Investigation on the Demand of Dying Patients' Families on Hospice Care Knowledge

    Institute of Scientific and Technical Information of China (English)

    张宇平; 诸海燕; 马红丽

    2016-01-01

    Objective To learn the demand of dying patients' families in general hospital so as to improve the effectiveness and pertinence of education measures.Method Self-designed survey was adopted in the investigation. The questionnaire included general information of patients' families, their demand of hospice care knowledge and its proper forms and methods. Patients' families should fill the questionnaire. However, when they are incompetent, training nurses could fill the questionnaire by means of questions and answers.Results Through this investigation, we found that there was a clear correlation between the awareness of patients' families on hospice care and education level and age. The awareness of patients' families on hospice care knowledge had been significantly improved after intervention.Conclusion Strengthen the education of hospice care knowledge to dying patients' families and meet their demand of relevant knowledge. Various means should be carried out to popularize hospice care knowledge and death education should be promoted so that people could have a rational attitude towards death and accept hospice care.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Herausforderungen durch die deutsche Wiedervereinigung

    Science.gov (United States)

    Stäglin, Reiner

    Die Wiedervereinigung stellte auch die Statistik vor große Aufgaben. Die als Organ der staatlichen Planung staatsnah orientierte Statistik der DDR musste auf das zur Neutralität und wissenschaftlichen Unabhängigkeit verpflichtete System der Bundesrepublik umgestellt werden. Ebenso verlangten die Universitäten eine Neuorientierung. Die Deutsche Statistische Gesellschaft hat sich vor allem dreier Aufgaben mit großem Engagement, aber auch mit Bedachtsamkeit angenommen: Aufnahme und Integration der Statistiker aus den neuen Bundesländern in die Gesellschaft, Begleitung der Neuausrichtung des Faches Statistik an deren Hochschulen und Sicherung sowie Nutzung von Datenbeständen der ehemaligen DDR.

  1. Gedagtes oor die begin van die kerk - 'n geskiedenis van ...

    African Journals Online (AJOL)

    seriously, affirm, and thankfully acknowledge Christendom, the. Church. We must ... In all this we at least approached the theology and practice of a spiritual partisan ..... Hegel se geskiedsfilosofie hou juis 'sintese' voor as die eindpunt van die.

  2. 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.

  3. Film Presentation: Die Urknallmaschine

    CERN Multimedia

    Carolyn Lee

    2010-01-01

    Die Urknallmaschine, an Austrian film by Gerd Baldauf, narrated by Norbert Frischauf (Alpha Österreich - ORF, 2009).  In CERN’s gigantic complex particles are accelerated to almost the speed of light, brought to collision and made to divide into even smaller particles. Public opinion of CERN’s research is also divided. Sceptics fear that black holes may be created. Might the goal to study the origin of the world lead to its destruction? The Austrian researcher Norbert Frischauf worked at CERN for many years. With his guidance it is possible to explore the world’s largest research centre, get a glimpse of the fascinating work the scientists do there and take a crash course in particle physics. Die Urknallmaschine will be presented on Friday, 25 June from 13:00 to 14:00 in the Main Auditorium. Language: German

  4. Dying for security

    Directory of Open Access Journals (Sweden)

    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.

  5. 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.

  6. Die onderrigtaak van die verpleegpraktisyn in die saalsituasie

    Directory of Open Access Journals (Sweden)

    M.E.C. Potgieter

    1980-09-01

    Full Text Available The ward sister, being the senior nurse practitioner on the ward, has an important teaching task. This teaching, although mainly directed towards the student nurse, also includes all categories of workers in the ward as well as the patient and his family. Teaching on the ward mainly takes place on an informal basis, but some methods of formal teaching can be used with excellent results.

  7. Die medizinische Diskussion um die Fettleibigkeit 1800-1914

    OpenAIRE

    Holstermann, Inga Kristine

    2012-01-01

    Gegenstand der Untersuchung ist die medizinische Diskussion um die Fettleibigkeit von 1800 bis 1914. Dargestellt werden die unterschiedlichen Betrachtungsweisen der Fettleibigkeit beeinflusst durch gesellschaftliche, industrielle und medizinische Entwicklungen im Untersuchungszeitraum unter den Aspekten der Ursachen (Lebensführung, erbliche Veranlagung, Geschlecht, Alter, Stoffwechselstörungen) und Folgen (Gesundheitsgefahren, Ästhetik, psychische Auswirkungen). Des weiteren werden Konzepte z...

  8. 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.

  9. Geslagsverskille in die ouditiewe ontlokte potensiaal van die brein

    Directory of Open Access Journals (Sweden)

    Anita D Stuart

    2006-04-01

    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.

  10. [Care costs and activity in the last three months of life of cancer patients who died in the Basque Country (Spain)].

    Science.gov (United States)

    Nuño-Solinís, Roberto; Herrera Molina, Emilio; Librada Flores, Silvia; Orueta Mendía, Juan F; Cabrera-León, Andrés

    2016-10-01

    To analyse the use of health resources and its budget in the last months of life of the population who died from malignant neoplasm in the Basque Autonomous Country (Spain). Retrospective observational study of a population with a diagnosis of malignancy deceased in the Basque Country (2010 and 2011). MDS and Mortality Register. gender, age, place of death, tumour location, clinical activity data and costs in the last three months of life. We performed a descriptive analysis of clinical activity and costs, and lineal multivariate regressions to obtain the adjusted mean costs by gender, age and place of death. 9,333 deaths from malignancy were identified in 2010 and 2011. 65.4% were men, 61.5% aged 70 or over, mean age 72.9 years, 71.1% died in hospital. People who died in the hospital had an average cost of about double that of the people who died at home (€14,794 and €7,491, respectively; p <0.001) and 31.3% higher than in the nursing home (€11,269; p <0.001). Greater interventions at the end of life at the community level are necessary, strengthening the care capacity of primary health care, both from training and support from expert teams in order to change the current care profile to a more outpatient care that allows a lower consumption of resources and greater care at home. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Should assisted dying be legalised?

    Science.gov (United States)

    2014-01-01

    When an individual facing intractable pain is given an estimate of a few months to live, does hastening death become a viable and legitimate alternative for willing patients? Has the time come for physicians to do away with the traditional notion of healthcare as maintaining or improving physical and mental health, and instead accept their own limitations by facilitating death when requested? The Universities of Oxford and Cambridge held the 2013 Varsity Medical Debate on the motion “This House Would Legalise Assisted Dying”. This article summarises the key arguments developed over the course of the debate. We will explore how assisted dying can affect both the patient and doctor; the nature of consent and limits of autonomy; the effects on society; the viability of a proposed model; and, perhaps most importantly, the potential need for the practice within our current medico-legal framework. PMID:24423249

  12. Verrekening van die kragveld van die verbond in die inkleding van die kommunikatiewe driehoeksverhouding tussen teks, hoorder en prediker

    Directory of Open Access Journals (Sweden)

    Friedrich W. de Wet

    2012-09-01

    Full Text Available In hierdie artikel word die kommunikatiewe driehoeksverhouding tussen die Bybelse teks, die hoorders en die prediker homileties verken. Die probleemstelling waarmee gewerk word handel oor potensiële versteurings wat kan plaasvind in hierdie driehoeksverhouding wanneer die hoorders en die prediker in hulle menslike beperktheid in verbinding gebring word met die ewige Woord van God soos dit in die Bybelse teks na vore kom. In die loop van die artikel word die volgende aspekte verken: ’n Ideale tipering van die verhouding tussen die teks, hoorders en prediker waarin al drie faktore ’n regmatige plek het; die maniere waarop die kommunikatiewe driehoek in die spanningsveld tussen teks, hoorders en prediker kan skeeftrek; en pneumatologiese verankering van die kommunikatiewe driehoek in die kragveld van die verbondsruimte, waarin Jesus Christus versoenend (integrerend teenwoordig is. Die gevolgtrekking waartoe gekom word, is dat die prediker in die kragveld van die verbond in staat gestel word om getrou te bly aan die teks (waarin God aan die Woord kom, aan die hoorders (as mededeelgenote in die genade van God sowel as – in missionêre konteks – mense wat geroep word om deelgenote in hierdie genade te word en aan hom- of haarself (as nuwe mens in Christus sonder dat die verbintenis aan een element in die  kommunikatiewe driehoek die verbintenis aan die ander versteur of laat disintegreer.Reckoning with the force field of the covenant in aligning the communicative triangle between text, listener and preacher. In this article the communicative triangular relationship between the Biblical text, the listeners and the preacher is reflected upon from a homiletic point of view. The problem statement deals with potential distortions in this triangular relationship when the listeners and preacher (in their human finitude are brought into contact with the eternal Word of God as it proceeds from the Biblical text. In the course of the article the

  13. Die amtliche Kinder- und Jugendhilfestatistik

    OpenAIRE

    Schilling, Matthias

    2003-01-01

    Unter Rückgriff auf verschiedene wissenschaftliche Methoden umfasst die Dissertation eine differenzierte Untersuchung der amtlichen Kinder- und Jugendhilfestatistik (KJH-Statistik). Da die wissenschaftliche Sozialpädagogik erst langsam und zögerlich beginnt, die amtliche Statistik der Kinder- und Jugendhilfe wahrzunehmen, liegt das Forschungsinteresse darin, dass eine grundlegende und umfassende wissenschaftliche Analyse der Möglichkeiten und Grenzen der KJH-Statistik vorgenommen wird. Die KJ...

  14. 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

  15. 50例舒缓患者音乐疗法生活质量影响观察%Observation of the impact of music therapy on the life quality of dying patients

    Institute of Scientific and Technical Information of China (English)

    冷海燕; 吴玉华

    2014-01-01

    目的:探讨音乐疗法对临终患者生活质量的影响。方法:选择舒缓疗护病房100例患者,实验组和对照组各50例。对照组给予常规治疗及护理,实验组增加音乐疗法干预,每次30 min,1次/d。结果:两组患者心率、疼痛指标和远期生活质量比较差异有统计学意义(P<0.05);两组患者呼吸和血压指标差异无统计学意义。结论:音乐疗法能缓解舒缓患者疼痛症状,提高生活质量。%Objective:To explore the impact of music therapy on the life quality of dying patients. Methods:In the soothing palliative care wards 100 dying patients were selected and divided into the experiment group and the control group with 50 patients each. The control group received conventional treatment and care. The experiment group was added music therapy intervention 30 minutes each, once a day besides the conventional treatment and care. Results:The heart rate, pain index and long term life quality of the two groups were compared and their difference had statistical signiifcance (P<0.05). Their respiratory and blood pressure had no statistical difference. Conclusion:Music therapy can relieve the pain symptoms of dying patients and improve their life quality.

  16. Gods hand in die natuur

    Directory of Open Access Journals (Sweden)

    A. Duvenage

    1966-03-01

    Full Text Available Kan ons van so iets spreek? Daaroor bestaan daar seker geen verskil nie. Die Bybel is vol daarvan van Genesis tot Openbaring. God is Skepper. ’n Ander vraag is of ons God ook kan ken uit wat daar in die natuur gebeur? Verloop alles nie maar volgens ewige natuurwette waaraan tog niks verander kan word nie? Ons bely egter dat die Here nie net in die hart van die mens gelê het wat ons noem die „saad van die religie” nie (semen religionis, maar dat ons Hom ook ken deur die skep- ping, onderhouding en regering van die hele wêreld, aangesien dit voor ons oë is soos ’n mooi boek waarin alle skepsels, groot en klein, die letters is wat ons die onsigbare dinge van God duidelik laat sien, nl. sy ewige krag en Goddelikheid ...; dinge wat almal genoegsaam is om die mense te oortuig en hulle alle verontskuldiging te ontneem (Art. 2 Ned. Gel. Bel..

  17. Die eunug in die klassieke mitologie en samelewing

    Directory of Open Access Journals (Sweden)

    F. P. Retief

    2002-09-01

    Full Text Available Die konsep, eunug, wat na ’n gekastreerde persoon (gewoonlik manlik verwys, het sy oorsprong in die mitologie. Van hier word dit deurgevolg na die Klassieke tydperk. Kastrering vir religieuse redes was deel van godsdiensrituele gekoppel aan verering van aardgodinne en fertiliteit. Die kultusse wat aan die godinne Kubele, Hekate, Atargatis-Dea, Astarte, Artemis en Innana-Ishtar gewy was en wat deur eunugpriesters bedien was, word beskryf. Kastrering vir niereligieuse redes, oorwegend weens sosio-ekonomiese oorwegings, het waarskynlik tydens die 2de millennium v.C. sy oorsprong in Midde-Oosterse lande gehad vanwaar dit teen ongeveer die 5de eeu v.C. na Griekeland, en twee eeue later na Rome uitgebrei het. ’n Oorsig word gelewer van die invloed en rol van die eunug ten tye van die klassieke beskawing. Die sogenaamde “kongenitale eunug” waar hipogonadisme weens ’n aangebore letsel ontstaan, ’n baie seldsame verskynsel, word nie verder bespreek nie.

  18. Aard, funksie en invloed van die Literatuur

    Directory of Open Access Journals (Sweden)

    J. van der Elst

    1981-05-01

    Full Text Available Binne die raam werk van die tema van hierdie simposium gaan dit om twee komponente:die Literatuur, meer bepaald die letterkundige werk of woordkunswerk met sy drie genres endie gemeenskap, die onlvangers of belewers van die Literatuur of doodgewoon die lesers.

  19. Videobasierte Unterrichtsbeobachtung: die Quadratur des Zirkels?

    OpenAIRE

    Fankhauser, Regula

    2012-01-01

    Seit einigen Jahren wird Unterrichtsforschung vermehrt videobasiert angegangen. Die methodologische Diskussion, die die Weiterentwicklung des Instrumentariums begleitet, kreist dabei zentral um die Frage der Invasivität der Aufzeichnungstechnik und möglicher Kameraeffekte. Je nach methodologischer Ausrichtung wird diesem Problem anders begegnet: So versucht die abbildtheoretische Unterrichtsvideografie, die Invasivität zu kontrollieren. Qualitative Methoden wie die Kameraethnografie dagegen m...

  20. Die wisselende rol van kontinuïteit en diskontinuïteit in die geskiedenis van die filosofie en die wiskunde

    Directory of Open Access Journals (Sweden)

    Danie F.M. Strauss

    2017-01-01

    Full Text Available Hierdie artikel wil lig werp op die onvermydelikheid van diskreetheid en kontinuïteit as primitiewe (ondefinieerbare verklaringswyses in die geskiedenis van die filosofie en die wiskunde. Dit beliggaam die algemene uitdaging om rekenskap van die samehang van iets wat uniek is te gee. Gödel beklemtoon die samehang van ‘primitiewe begrippe’. Die Griekse filosofie het reeds die ruimtelike geheel-dele-relasie – en die oneindige verdeelbaarheid daarvan – ontdek. Gedurende en na die Middeleeue het filosowe wipplank gery tussen ’n atomistiese waardering van die kontinuum en die teenoorgestelde daarvan, wat byvoorbeeld in die denke van Leibniz aangetref word as die gepostuleerde wet van kontinuïteit (lex continui. Die ontdekking van ‘inkommensurabiliteit’ (irrasionale getalle deur die Grieke het aanleiding gegee tot die eerste grondslagkrisis van die wiskunde en die geometrisering daarvan. Leibniz en Newton kon die probleme rondom die limietbegrip nie besleg nie en spoedig sou dit tot die derde grondslagkrisis van die wiskunde aanleiding gee. Dit het Frege en die ‘kontinuum-teoretici’ daartoe gebring om prioriteit aan die kontinuum te gee – diskreetheid is ’n katastrofe. Onlangs waardeer Smooth Infinitesimal Analysis kontinuïteit as iets wat ’n ‘ongebroke en ononderbroke geheel’ daarstel. Die intuïsionistiese wiskunde het opnuut aangesluit by die klem op die ruimtelike geheel-dele-relasie. Ondanks pogings om kontinuïteit eksklusief aritmeties en ruimtelik te verstaan bevestig die geskiedenis van die filosofie en die wiskunde onmiskenbaar dat die medekondisionerende rol van hierdie twee wyses van verklaring ’n konstante metgesel in die nadenke oor kontinuïteit en diskontinuïteit sou bly. (Die rol van kontinuïteit en diskontinuïteit in die fisika en biologie sal in ’n aparte artikel ondersoek word.

  1. Reuchlin und die Kabbala

    OpenAIRE

    2008-01-01

    Auszug: Hundert Jahre nachdem Johannes Reuchlin sein wissenschaftliches Werk vollendet hatte, war der von ihm hinterlassene Eindruck auf die europäische Wissenschaft und das europäische Denken so nachdrücklich, daß er - liebe- oder vorwurfsvoll - einmal >Rabbi Capnion< genannt wurde. Und wirklich - so meint Joseph Blau in seiner Darstellung der christlichen Kabbala - habe Reuchlin der hebräischen Literatur mehr gedient als mancher ordentliche Rabbiner. Ähnlich hat Gershom Scholem, der Begründ...

  2. Die Mythosphilosophie Ernst Cassirers

    DEFF Research Database (Denmark)

    Pedersen, Esther Oluffa

    Bogen undersøger Ernst Cassirers filosofiske hovedværk - Die Philosophie der symbolischen Formen - for at finde frem til, hvilken betydning det har, at Cassirer inddrager myten som den menneskelige kulturs grundform og dermed på mange måder sidestillet med videnskab, sprog og kunst. Der...... argumenteres for, at netop arbejdet med myten muliggjorde en frugtbar åbning af erkendelsesteorien i retning af udtryksfænomenet og følelsers betydning for menneskets livsverden. Bogens anden del ser nærmere på, hvordan Cassirer bruger sin mytefilosofi fra 1920'erne til at forstå 1940'ernes fascistiske...

  3. [Twelve years of working of Brazzaville cancer registry].

    Science.gov (United States)

    Nsondé Malanda, Judith; Nkoua Mbon, Jean Bernard; Bambara, Augustin Tozoula; Ibara, Gérard; Minga, Benoît; Nkoua Epala, Brice; Gombé Mbalawa, Charles

    2013-02-01

    The Brazzaville cancer registry was created in 1996 with the support of the International Agency Research against Cancer (IARC) which is located in Lyon, France. The Brazzaville cancer registry is a registry which is based on population which records new cancer cases occurring in Brazzaville by using Canreg 4.0 Software. Its aim is to supply useful information to fight against cancer to physicians and to decision makers. We conducted this study whose target was to determine the incidence of cancer in Brazzaville during twelve years, from January 1st, 1998 to December 31, 2009. During that period 6,048 new cancer cases were recorded: 3,377 women (55.8%), 2,384 men (39.4%), and 287 children (4.8%) from 0 to 14 years old with an annual average of 504 cases. Middle age to the patient's diagnosis was 49.5 years in female sex and 505.5 years old for male sex. The incidence rate of cancers in Brazzaville was 39.8 or 100.000 inhabitants per year and by sex we observed 49 to female sex and 35.2 for male sex. The first cancers localizations observed to women were in order of frequency: breast, cervix uterine, liver ovaries, hematopoietic system, to men : liver, prostate, hematopoietic system, colon and stomach; to children : retina, kidney, hematopoietic system, liver and bones. These rates are the basis to know the burden of cancer among all pathologies of Brazzaville and the achievement of a national cancer control program.

  4. The twelve dimensional super (2+2)-brane

    CERN Document Server

    Hewson, S F

    1996-01-01

    We discuss supersymmetry in twelve dimensions and present a covariant supersymmetric action for a brane with worldsheet signature (2,2), called a super (2+2)-brane, propagating in the osp(64,12) superspace. This superspace is explicitly constructed, and is trivial in the sense that the spinorial part is a trivial bundle over spacetime, unlike the twisted superspace of usual Poincare supersymmetry. For consistency, it is necessary to take a projection of the superspace. This is the same as the projection required for worldvolume supersymmetry. Upon compactification of this superspace, a torsion is naturally introduced and we produce the membrane and type IIB string actions in 11 and 10 dimensional Minkowski spacetimes. In addition, the compactification of the twelve dimensional supersymmetry algebra produces the correct algebras for these theories, including central charges. These considerations thus give the type IIB string and M-theory a single twelve dimensional origin.

  5. Die ideaal van die spreker in die satiriese gedig: M.M. Walters

    Directory of Open Access Journals (Sweden)

    S. M. Cameron

    1980-05-01

    Full Text Available Wanneer van die satirikus gepraat word, word eintlik die spreker in die satiriese gedig veronderstel. “For the Muse ought always to be our reminder that it is not the author as man who casts these shadows on our printed page, but the author as poet” (Mack, 1971:193.

  6. Die historiese Jesus, die Jesus-beweging en die vorming van die kerk

    Directory of Open Access Journals (Sweden)

    Andries van Aarde

    1995-01-01

    Full Text Available The historical Jesus, the Jesus movement and the birth of the church. The article focuses on the birth of the church. The point at which the church began its existence is located within the boundaries of fonnative Judaism. The parting of the ways is explained as a movement from faction to sect, to the eventual fonnation of the church in its own right as distinct from the synagogue. The historical Jesus should therefore not be seen as the founder of the church. However, the article argues that the relation of the life and death of the historical Jesus to the resurrection belief of the post-paschal Jesus movement constitutes the cradle of the church. This continuum between Jesus and New Testament Christendom is referred to by means of the Gennan phrase die Sache Jesu. Reconsideration of this trajectory results in the conviction that the vision and program of the historical Jesus cannot be neglected when one reflects on the nature of the church in the New Testament or on the vocation of the church through history to the present day. Two thought complexes form the kernel of die Sache Jesu: God's unbounded presence and the concept that everyone has unmediated and non-hierarchical access to the grace of God.

  7. Die hermeneutiek van gereformeerde kerkreg

    Directory of Open Access Journals (Sweden)

    Andries le Roux du Plooy

    2012-09-01

    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

  8. Postoperative MRI findings after anterior cruciate ligament reconstruction. A prospective study with 50 patients; Die postoperative MRT-Morphologie des vorderen Kreuzbandes nach primaerer Bandnaht oder Bandplastik. Eine prospektive Studie an 50 Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Uhl, M. [Abt. Radiodiagnostik, Chirurgische Klinik und Poliklinik, Sektion Unfall- und Wiederherstellungschirurgie, Universitaetsklinik Heidelberg (Germany); Schmidt, C. [Abt. Radiodiagnostik, Chirurgische Klinik und Poliklinik, Sektion Unfall- und Wiederherstellungschirurgie, Universitaetsklinik Heidelberg (Germany); Riedl, S. [Abt. Radiodiagnostik, Chirurgische Klinik und Poliklinik, Sektion Unfall- und Wiederherstellungschirurgie, Universitaetsklinik Heidelberg (Germany); Brado, M. [Abt. Radiodiagnostik, Chirurgische Klinik und Poliklinik, Sektion Unfall- und Wiederherstellungschirurgie, Universitaetsklinik Heidelberg (Germany); Kauffmann, G.W. [Abt. Radiodiagnostik, Chirurgische Klinik und Poliklinik, Sektion Unfall- und Wiederherstellungschirurgie, Universitaetsklinik Heidelberg (Germany); Friedl, W. [Abt. Radiodiagnostik, Chirurgische Klinik und Poliklinik, Sektion Unfall- und Wiederherstellungschirurgie, Universitaetsklinik Heidelberg (Germany)

    1996-01-01

    Aim: Identification of typical postoperative change after anterior cruciate ligament reconstruction (sutures, tendon grafts) and comparison with clinical tests and ultrasound. Patients and methods: 50 patients with anterior cruciate ligament ruptures were examinated with MRI (1.0 T, surface coil, sagittal T{sub 1}-3DFT-Fast and sagittal spin-echo), US and clinical function tests (Lachmann, pivot-shift, anterior drawer test). Results: In 19 of 21 patients with continuous low-intensity ligament structures in the MRI, knee stability was very good or good in the clinical tests and US. In 17 of 20 patients with a diagnosis of partial rupture at MRI, we also found a stable knee. 5 of 7 patients with the MRI-signs of ligament rupture showed knee stability at US and clinical tests. Furthermore, at MRI we found minor effusions in 10 patients, meniscus tears in 8 patients and ligament impingement in 2 patients. Conclusion: MRI is a valuable method for evaluating and assessing anterior ligament reconstructions. We found a good correlation between the continuous low-intensity ligaments at MRI and knee-stability. In contrast there is a bad correlation between discontinuous ligament structures at MRI and clinical stability of the knee. MRI seems to provide more information than US and clinical tests (for example: minor effusion, meniscus tears, ligament impingement, bone lesions). (orig.) [Deutsch] Methode: 50 Patienten mit Rekonstruktionen des vorderen Kreuzbandes (43 primaere Bandnaehte, 7 Sehnenplastiken) wurden 2-5 Jahre postoperativ mittels MRT, (1,0 T Picker, Oberflaechenspule, sagittale 1,5 mm dicke MRT-Schichten in T{sub 1}-3DFT-Fast) und Gelenkultraschall untersucht und einer detaillierten uniformen klinischen Untersuchung inklusive Lachmann-Test, vordere Schublade und Pivot-Shift unterzogen. Ergebnisse: Bei 19 von 21 Patienten mit durchgehend signalarm dargestelltem vorderen Kreuzband waren die Stabilitaetsverhaeltnisse des Kniegelenkes klinisch und sonographisch gut

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

    Directory of Open Access Journals (Sweden)

    Johan Buitendag

    2012-09-01

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Killing, letting die and moral perception.

    Science.gov (United States)

    Gillett, Grant

    1994-10-01

    There are a number of arguments that purport to show, in general terms, that there is no difference between killing and letting die. These are used to justify active euthanasia on the basis of the reasons given for allowing patients to die. I argue that the general and abstract arguments fail to take account of the complex and particular situations which are found in the care of those with terminal illness. When in such situations, there are perceptions and intuitions available that do not easily find propositional form but lead most of those whose practice is in the care of the dying to resist active euthanasia. I make a plea for their intuitions to be heeded above the sterile voice of abstract premises and arguments by examining the completeness of the outline form of the pro-euthanasia argument. In doing so, I make use of Nussbaum's discussion of moral perception and general claims to be found in the literature of moral particularism.

  12. Acts and omissions, killing and letting die.

    Science.gov (United States)

    Gillon, R

    1986-01-11

    Gillon asks what, if any, moral importance resides in the distinction between killing and letting die in the context of medical care. He considers and rejects the acts and omissions doctrine, which claims that actions (killing) resulting in some undesirable end are in general morally worse than failures to act (allowing to die) that have the same result. He also refutes the argument that the moral distinction between killing and letting die is one of harming versus benefitting, and that a physician has a responsibility not to harm (kill) a patient but no duty to help (keep alive). Gillon concludes by discussing the moral claims upon which the Roman Catholic rejection of the acts and omissions doctrine is based, which are the subjects of his next British Medical Journal article on medical ethics.

  13. 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

    Directory of Open Access Journals (Sweden)

    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.

  14. Die gebruik van metode in die filosofie, spesiaal in die reformatoriese tra­disie 1

    Directory of Open Access Journals (Sweden)

    N. T. van der Merwe

    1983-03-01

    Full Text Available Die onderw erp van my voordrag, Die gebruik van metode in die fílosofie, verg ’n paar verduidelikende opinerkings vooraf. Ek dink u verm oed alreeds dat hierdie fomulering ’n versuikerde pil is om u in so ’n mate nuuskierig te maak dat una ’n heerlike vrye filosofiese ‘onderonsie’ gedurende die teepouse darem vir ’n tw eede sessie terugkeer. Want is dit nie twee smaaklike heuningdruppels nie: filosofie en sy metode’ en ‘metode in die Reformatoriese filosofiese tradisie'?! Veral as in gedagte gehou word dat in teenstelling met wat ’n mens sou verw ag, daaroor dié onderwerp as sodanig relatief maar heel weinig geskrywe is en word, selfs as die ‘Inleidings in die Metodologie’ daarby gereken word.

  15. Die derivation der slowenischen substantive

    Directory of Open Access Journals (Sweden)

    ]ože Toporišič

    1975-11-01

    Full Text Available Von der traditionellen slowenischen Wortbildungslehre von Substantiven mit den Suffixen (s. g. Derivation wird die betreffende Problematik so dargestellt, dass man - nach Miklošič's Vorbild - von Suffixen mit einem charakteristischen Konsonanten (oder mit eine charakteristischen Konsonantengruppe aus gehend bei verschiedenen Wortartbasen (Zeitwort, Adjektiv, Substantiv die semantischen kategorien von Wortbildungen mit »demselben« Suffix aufzählt. Aber schon bei A. Bajec (Besedotvorje slovenskega jezika, 1950 findet man auch das Kapitel »Die Suffixe nach ihren Bedeutungen, worin Suffixe für 24 Bedeutungsgruppen festgehalten sind. In der Slovenska slovnica (1956 gibt es 16, im Slovenski knjižni jezik 2 (1966 aber 13 solcher Gruppen von Suffixen. Der vorliegende Ausatz geht ebenfalls von den semantischen Kategorien aus, versucht aber die Zahl der Bedeutungskategorien, die aus verhalen, adjekvsehen oder substantiviseher Basen mit Hilfe von Suffixen gebildet werden, auf 6 grosse Gruppen zu reduzieren. Diese 6 Gruppen sind: 1. die Namen der Agenten, des Eigenschaftstragers und der Verbundenheit; 2. die Namen der Werkzeuge, 3. die Namen der Handlung, der Eigenschaft und des Zustandes, 4. die Namen der vergegenständlichten Tat oder Eigenschaft, 5. die Namen der Lokalisierung und 6. Verschiedene. Nur bei den Wortbildungen aus einer substantivischen Basis gibt es noch eine besondere, die s. g. Modifikationsbedeutungsgruppe (Feminativa und Maskulinativa, Kollektiva, Gradativa, Iuvenalia, Diminutiva, Diminutivhipokoristika, Diminutivpeirotiva und Peiorativa. - Dabei wird keine Riick­ sicht darauf genommen, ob diese Suffixe genain slowenisch oder aus anderen Sprachen übernommen sind. Die Berechtigung dafiir gibt uns nicht nur die produktive Wortbildung mit den entlehnten (nichtautochtonen Suffixen im gegenwärtigen Slowenisch, sondern (was noch wichtiger ist auch das richtige Verständnisvermögen der Sprecher für solche Wortbildungen im

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Die heelal en sy onstaan (II

    Directory of Open Access Journals (Sweden)

    D. J. Van Rooy

    1952-03-01

    Full Text Available Ons kennis en wetenskap van die hemelliggame word volkome bepaal deur die lig wat ons van hulle ontvang, d.w.s. as ons die feite wat die Bybel daaromtrent meedeel, buite rekening laat.

  18. Spearman se G en die faktorstrukture van die senior aanlegtoetse en die algemene skolastiese aanlegtoets

    Directory of Open Access Journals (Sweden)

    G. P. De Bruin

    1997-06-01

    Full Text Available Spearman's G and the factor structures of the Senior Aptlitude Test and the General Scholastic Aptitude Test. Scores of 1507 university students on the six subtests of the General Scholastic Aptitude Test (GSAT and on nine subtests of the Senior Aptitude Tests (SAT were subjected to a joint confirmatory factor analysis. This procedure was followed to examine (a the extent to which scores in respect of the two batteries of tests, are explained by a general factor (Spearman's g, and (b the relationship between the two general factors. Scores on the GSAT subtests were adequately explained by just one factor. With regard to the SAT three group factors could be distinguished, namely Verbal Ability, Visual-Spatial Ability and Numerical Ability. The correlations between the group factors were so high that the influence of a general factor was evident. The general factors underlying the SAT and GSAT respectively, also correlated significantly. In view of findings suggesting the general intelligence is the best single predictor of criteria such as academic success and work performance, the GSAT is recommended for selection purposes. Opsomming Tellings van 1507 universiteitstudente op die ses subtoetse van die ASAT en nege subtoetse van die SAT, is gesamentlik aan 'n bevestigende faktorontleding onderwerp. Hierdie prosedure is gevolg om ondersoek in te stel na (a die mate waartoe 'n algemene faktor (Spearman se g die tellings op die twee batterye toetse onderskeidelik onderle, en (b wat die verwantskap tussen die twee algemene faktore sou wees. Ten opsigte van die ASAT is dit duidelik dat slegs een faktor tellings op al ses subtoetse verklaar. Ten opsigte van die SAT kon drie groepsfaktore onderskei word/ naamlik Verbale Vermoe, Visueel-Ruimtelike Vermoe en Numeriese Vermoe. Die korrelasies tussen die drie groepsfaktore was egter so hoog dat dit duidelik is dat daar 'n algemene faktor onderliggend is aan die nege subtoetse. Die algemene faktore wat die

  19. Die MCI im Wandel: User Experience als die zentrale Herausforderung?

    OpenAIRE

    Jetter, Christian

    2006-01-01

    Die Informationstechnologie hat heute einen Reifegrad erlangt, der stark umkämpfte Massenmärkte von interaktiven Produkten hervorgebracht hat. In diesen sind - wie auch in den herkömmlichen Konsumgütermärkten - nicht nur die pragmatische Produktqualität, sondern auch das Benutzungserlebnis und die Gesamtwirkung auf den Käufer entscheidend für den Markterfolg. Eine erfolgreiche Gestaltung dieser "User Experience" geht dabei über die reine Softwareergonomie hinaus und erfordert interdisziplinär...

  20. The strong coupling regime of twelve flavors QCD

    NARCIS (Netherlands)

    Silva, Tiago Nunes da; Pallante, Elisabetta

    2012-01-01

    We summarize the results recently reported in Ref.[1] [A. Deuzeman, M.P. Lombardo, T. Nunes da Silva and E. Pallante,"The bulk transition of QCD with twelve flavors and the role of improvement"] for the SU(3) gauge theory with Nf=12 fundamental flavors, and we add some numerical evidence and theoret

  1. EFFORTS Technical annex for the twelve month progress report

    DEFF Research Database (Denmark)

    Andreasen, Jan Lasson; Eriksen, Morten; Thomas christensen, Thomas Vennick;

    The present report is documentation for the work carried out at DTU during the second year of project activity. The report describes the work completed by DTU in general as well as on the active sub-tasks within materials properties, friction modelling and physical modelling, over the last twelve...

  2. Human Evolution in Science Textbooks from Twelve Different Countries

    Science.gov (United States)

    Quessada, Marie-Pierre; Clement, Pierre; Oerke, Britta; Valente, Adriana

    2008-01-01

    What kinds of images of human beings illustrate human evolution in school textbooks? A comparison between the textbooks of eighteen different countries (twelve European countries and six non-European countries) was attempted. In six countries (Algeria, Malta, Morocco, Mozambique, Portugal, and Tunisia), we did not find any chapter on the topic of…

  3. Bibliography of Spanish Materials for Students, Grades Seven through Twelve.

    Science.gov (United States)

    California State Dept. of Education, Sacramento.

    This annotated bibliography of Spanish materials for students in grades seven through twelve is divided into the following categories: (1) Art, Drama, Music, and Poetry; (2) Books in Series; (3) Culture; (4) Dictionaries and Encyclopedias; (5) Literature; (6) Mathematics; (7) Physical Education, Health, and Recreation; (8) Reading and Language…

  4. Meganisisme, vitalisme en holisme in die Biologie

    Directory of Open Access Journals (Sweden)

    P.J. Botha

    1963-03-01

    Full Text Available Die Biologie word omskryf as die wetenskap van die lewende wesens (organismes. Die lewe staan dus in die brandpunt van die biologiese studie en ondersoek. Vra ons ons egter af wat onder „lewe” verstaan word, besef ons dadelik dat ons hier met ’n uiters moeilik definieerbare begrip te doen het. In verband met die aard van lewe het daar onder die bioloë en natuurfilosowe veral twee denkrigtings posgevat, nl. meganisisme en vitalism.

  5. Post-traumatic syringomyelia; Die posttraumatische Syringomyelie

    Energy Technology Data Exchange (ETDEWEB)

    Freund, M.; Sartor, K. [Universitaetsklinikum Heidelberg (Germany). Abt. Neuroradiologie; Aschoff, A. [Universitaetsklinikum Heidelberg (Germany). Neurochirurgische Klinik; Spahn, B. [Universitaetsklinikum Heidelberg (Germany). Abt. Orthopaedie 2

    1999-12-01

    The improvement of preclinical emergency medicine, better surgical and conservative therapies, and the development of intensive care units and specialized centers have improved the survival rate for patients with serious spinal cord injuries. Therefore, more sequelae of chronic spinal cord injuries such as post-traumatic spinal cord cavitations also occur. The first such case was described by Bastian in 1867. Generally, these cavitations were diagnosed from 2 months up to 32 years after the trauma. The overall prevalence of post-traumatic syringomyelia (PTS) is not known; however, with the increasing use of magnetic resonance imaging (MRI), its diagnosis has increased, ranging from 2.3% of paraplegic and tetraplegic patients in 1976 and 3.2% in 1985, to nearly 50% in a selected group of patients in 1991 and 1993. In 1995, a 4.45% incidence was reported. In our clinic we are currently treating 440 cases of syringomyelia, 140 of which are PTS. Several observations suggest more than one potential mechanism for the evolution of a post-traumatic cyst or PTS. Various factors, such as hemorrhage or, in particular, ischemia within the spinal cord, blockage of the cerebrosinal fluid (CSF) pathways around the cord or localized meningeal fibrosis either alone or in combination with other factors, may be involved. Clinically, sensory disturbances, loss of motor function, pain, and modification of the deep tendon reflexes are observed in most patients. On MRI, PTS is seen as a longitudinal, cystic cavity within the spinal cord, giving a hypointense signal on T{sub 1}-weighted images and a hyperintense signal on T{sub 2}-weighted images. For treatment planning it is mandatory to identify the lower and upper end of the PTS on the MRI. (orig.) [German] Aufgrund der verbesserten medizinischen Versorgung schwer Rueckenmarkverletzter hat die Zahl der (Langzeit-) Ueberlebenden erheblich zugenommen. Allerdings koennen Spaetkomplikationen auftreten, die zu einer deutlichen Zunahme der

  6. Die mites rondom die val van Troje en Vergilius se uitbeelding daarvan in die tweede boek van die Aeneïs

    Directory of Open Access Journals (Sweden)

    J. Swanepoel

    1981-05-01

    Full Text Available Die mites oor die val van Troje vertel ’n aangrypende verhaal en in die tweede boek van die Aeneïs gee Vergilius op ’n besondere wyse gestalte daaraan. Maar Vergilius se vergestalting daarvan is slegs een van die variante van die verhaal.

  7. O uso da toxina botulínica no tratamento da distonia laríngea (disfonia espasmódica: estudo preliminar com doze pacientes Use of botulinum toxin in the treatment of laryngeal dystonia (spasmodic dysphonia: preliminary study of twelve patients

    Directory of Open Access Journals (Sweden)

    Hélio A. G. Teive

    2001-03-01

    Full Text Available A distonia laríngea (disfonia espasmódica é distúrbio do movimento caracterizado por contrações involuntárias da musculatura laríngea envolvida no processo de vocalização. A utilização da toxina botulínica no tratamento da distonia laríngea trouxe consideráveis benefícios clínicos. Descrevemos os resultados preliminares do uso terapêutico da toxina botulínica no tratamento da distonia laríngea em 12 pacientes. Após investigação clínica, os pacientes foram submetidos a videolaringoestroboscopia para confirmação diagnóstica e as injeções de toxina botulínica foram realizadas através de punção da membrana cricotireóidea em direção ao músculo tireoaritenóideo, com uso de eletromiografia. A maioria dos pacientes submetidos ao tratamento com toxina botulínica apresentou melhora significativa da distonia laríngea (83% dos casos, com duração média do efeito de quatro meses, sem efeitos colaterais significativos.Laryngeal dystonia (spasmodic dysphonia is a movement disorder characterized by involuntary contractions of laryngeal muscles involved with vocalization. The introduction of botulinum toxin in the treatment of laryngeal dystonia had a major clinical impact due to the striking improvement of symptoms. We report the preliminary results of therapeutical use of botulinum toxin in the treatment of twelve patients with laryngeal dystonia. After an extensive clinical evaluation, the patients underwent a videostroboscopic exam for diagnostic confirmation. Botulinum toxin was injected in the cricothyreoid membrane, directed towards the thyreoaritenoid muscle, with the aid of eletromyography needles. Most of patients who underwent botulinum toxin injection had a significant improvement of their symptoms (83%, with effects lasting for four months in average and without important side effects.

  8. Lady Di - Die moderne Madonna

    OpenAIRE

    Steuten, Ulrich; Strasser, Hermann

    2009-01-01

    Die authentischen Bekundungen von Trauer und Wertschätzung, die der bei einem Autounfall in Paris ums Leben gekommenen Prinzessin Diana weltweit entgegengebracht und seit Jahren von mehreren Seiten instrumentalisiert werden, sind unübersehbar. Das Leben und Sterben der Prinzessin von Wales ist nach Ansicht der Autoren geeignet, einer populären Mythenbildung in der modernen Gesellschaft Substanz zu verleihen. Vor allem bietet es die Möglichkeit, einen modernen Kult zu etablieren, der sich im Z...

  9. 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.

  10. Assistance in dying for older people without a serious medical condition who have a wish to die : a national cross-sectional survey

    NARCIS (Netherlands)

    Raijmakers, Natasja J H; van der Heide, Agnes; Kouwenhoven, Pauline S C|info:eu-repo/dai/nl/34166698X; van Thiel, Ghislaine J M W|info:eu-repo/dai/nl/150583265; van Delden, Johannes J M|info:eu-repo/dai/nl/086541331; Rietjens, Judith A C

    2015-01-01

    BACKGROUND: The Dutch euthanasia law regulates physician assistance in dying for patients who are suffering unbearably from a medical condition. We studied the attitudes of the Dutch population to assistance in dying for older persons who have a wish to die without the presence of a serious medical

  11. Assistance in dying for older people without a serious medical condition who have a wish to die: a national cross-sectional survey.

    NARCIS (Netherlands)

    Raijmakers, N.J.H.; Heide, A. van der; Kouwenhoven, P.S.C.; Thiel, G.J.M.W. van; Delden, J.J.M. van; Rietjens, J.A.C.

    2015-01-01

    Background: The Dutch euthanasia law regulates physician assistance in dying for patients who are suffering unbearably from a medical condition. We studied the attitudes of the Dutch population to assistance in dying for older persons who have a wish to die without the presence of a serious medical

  12. Assistance in dying for older people without a serious medical condition who have a wish to die : a national cross-sectional survey

    NARCIS (Netherlands)

    Raijmakers, Natasja J H; van der Heide, Agnes; Kouwenhoven, Pauline S C; van Thiel, Ghislaine J M W; van Delden, Johannes J M; Rietjens, Judith A C

    2015-01-01

    BACKGROUND: The Dutch euthanasia law regulates physician assistance in dying for patients who are suffering unbearably from a medical condition. We studied the attitudes of the Dutch population to assistance in dying for older persons who have a wish to die without the presence of a serious medical

  13. Neurokognitiewe integrasie en die leerproses

    Directory of Open Access Journals (Sweden)

    Johan J. Du Preez

    2013-02-01

    Full Text Available The purpose of this article, "Neuro-cognitive integration and the learning process'; is to find principles and strategies for the development of brain potential and the optimal integration of subject matter. Eight neuro-cognitive systems are identified and their importance to the integration of subject matter is emphasized. These systems are cortical energy, coding, planning and controlling, as well as the verbal sequential, non-verbal holistic, physical-motor, social effective and the subconscious. The relevant principles and strategies can serve as basis for mainstream and special education, guidance as well as psychotherapy. Die doe! met hierdie artikel is om beginsels en strategiee te vind om breinpotensiaal te ontsluit en leerstof optimaal te integreer. Aan die hand van 'n neurokognitiewe model word 'n aantal beginsels en strategiee bespreek en die verband met die leerproses word aangetoon. Agt neurokognitiewe sisteme is gei'dentifiseer en die belangrike rot wat dit speel ten opsigte van die integrasie van leerstof word beklemtoon. Genoemde sisteme sluit die volgende in: kortikale energie, kodering, beplanning en kontrolering, asook die verbaal-sekwensiele, nieverbaal- holistiese, fisiek-motoriese, sosio-affektiewe en die subbewuste. Genoemde beginsels en strategiee kan oak dien as grondslag vir hoofstroomonderwys, spesialiseringsonderwys, voorligting sowel as psigoterapie.

  14. Op die grens van vakwetenskap en filosofie

    Directory of Open Access Journals (Sweden)

    M Elaine Botha

    1976-03-01

    Full Text Available Die begrip “grens” soos dit voorkom in die titel is vir meerdere uitleg vatbaar. Eerstens sou dit kon dui op ’n onoorskreibare punt tussen die filosofie en die vakwetenskappe, so iets soos ’n grenspaal of baken, met ander woorde ’n punt van waterdigte skeiding tussen die domein van die filosofie en die vakwetenskappe. As ’n mens soms die dramatiese grensgevegte tussen die filo­ sofie en die vakwetenskappe in die wetenskaplike literatuur beskou1 dan blyk dit kennelik noodsaaklik te wees om wel sodanige grens te stel, veral ten einde die gevaar van weten­ skaplike terrorisme van die een of die ander kant die hoof te bied.

  15. Where is God in My Dying?

    DEFF Research Database (Denmark)

    Moestrup, R N 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...... observation to elucidate how hospice patients reflect and act upon their potential faith. The results demonstrate three dimensions of faith: (1) "Knowing" (cognition), (2) "doing" (praxis) and (3) "being" (meaning). The article concludes that most patients had a hesitant, but according to their situation...

  16. A twelve-week randomized controlled study of the cognitive-behavioral Integrated Psychological Therapy program: positive effect on the social functioning of schizophrenic patients Estudo controlado randomizado de 12 semanas do programa cognitivo-comportamental IPT (Terapia Psicológica Integrada com efeito positivo sobre o funcionamento social em pacientes com esquizofrenia

    Directory of Open Access Journals (Sweden)

    Marilene Zimmer

    2007-06-01

    Full Text Available OBJECTIVES: The present study was designed to evaluate the effect of twelve weekly sessions of the cognitive-behavioral program originally known as the Integriertes Psychologisches Therapieprogramm für Schizophrene Patienten, designated the Integrated Psychological Therapy (IPT program in English, on cognition, social adjustment and quality of life in schizophrenic outpatients, comparing it to the effect of treating such patients as usual. METHOD: Fifty-six adult outpatients (from 18 to 65 years of age with ICD-10-based diagnoses of schizophrenia were randomly assigned to two different groups: active intervention (IPT group; and treatment as usual (control group. Outcome measures were quality of life (as determined using the WHOQOL-Bref, cognition (Mini-Mental State Examination and Word Recall Test, global functioning (DSM-IV Global Assessment of Functioning Scale, social functioning (Social and Occupational Functioning Assessment Scale and social adjustment (Social Adjustment Scale. RESULTS: The findings suggest that, in comparison with treatment as usual (control group, the twelve-session IPT program had a positive effect on several outcome measures: cognition in the domains of spatiotemporal orientation (p = 0.051 and memory (p = 0.031; overall social adjustment (p = 0.037, leisure/social life (p = 0.051 and family relations (p = 0.008; overall functioning (p = 0.000; social-occupational functioning (p = 0.000; and quality of life in the psychological domain (p = 0.021. CONCLUSIONS: The twelve-session cognitive-behavioral IPT intervention demonstrated superiority over treatment as usual in its effects on cognition, social adjustment and quality of life. Studies involving larger samples, longer follow-up periods and additional outcome measures are needed in order to assess the specific effects on dimensions of social functioning, cognitive functioning and quality of life in patients with schizophrenia.OBJETIVOS: O presente estudo foi

  17. het die reformasie die leer gered en aanbidding verloor?

    African Journals Online (AJOL)

    B. Spoelstra, emeritusprofessor in Diakoniologiese Vakke, Fakulteit Teo- logie, P.U. vir C.H.O. (Skool vir ... Van der Leeuw sê liturgiek en leer is verwant en die geskiedenis van liturgie weerspieël die ...... VAN LEEUWEN G. 1946. Liturgiek.

  18. Is tamoxifen associated with an increased risk for thromboembolic complications in patients undergoing microvascular breast reconstruction? [Ist die Einnahme von Tamoxifen zum Zeitpunkt der mikrovaskulären Brustrekonstruktion mit einer erhöhten Rate an thrombembolischen Komplikationen assoziiert?

    Directory of Open Access Journals (Sweden)

    Krämer, Robert

    2013-02-01

    Full Text Available [english] Introduction: Tamoxifen is associated with a twofold increased risk of thromboembolic events. Third generation aromatase inhibitors (AIs, such as letrozole, anastrozole, and exemestane have therefore replaced tamoxifen in the adjuvant therapy of hormone receptor-positive breast cancer. A retrospective review was performed in patients who underwent delayed microvascular breast reconstruction and received tamoxifen at the time of surgery in order to assess the risk of both minor and major flap complications including thromboembolic events.Patients and methods: Twenty-nine patients who underwent delayed microsurgical breast reconstruction with autologous tissue between 2006 and 2012 were included in the study. The overall complication rates were compared between patients who did versus those who did not receive tamoxifen at the time of microsurgical breast reconstruction. Results: Breast reconstruction was performed with a DIEP flap in and with a TRAM flap in 4 patients. Overall, the complication rate was 37.9% (n=11 consisting of 5 major (including one total flap loss and 6 minor complications. In patients receiving tamoxifen (n=5, we observed one minor complication and one major complication with a total flap loss due to thrombus formation at the anastomosis site. In one patient pulmonary embolism occurred without association to tamoxifen. The number of thromboembolic events was equivalent in both groups (p=0.642. No increase of major (p=0.858 or minor (p=0.967 complications in the tamoxifen group could be observed. Taking the overall complication rate into account there was no statistically difference between the two groups (p=0.917.Conclusion: In our study we could not observe an increased risk for thromobembolic events in patients receiving tamoxifen while undergoing autologous microvascular breast reconstruction.[german] Aromatasehemmer der dritten Generation haben mittlerweile Tamoxifen in der neoadjuvanten und adjuvanten Therapie

  19. Die wysgerige konsepsie van Thomas van Aquino

    Directory of Open Access Journals (Sweden)

    Thomas Van Aquino

    1976-03-01

    Full Text Available Samevattend is tot dusver die volgende aangetoon: Die werklikheid vertoon volgens Thomas 'n hierargiese struktuur. Daar is verskillende grade van syn. God is die hoogste, die volheid van syn, en by die laere synsniveaus is daar steeds 'n verdere verwydering van hierdie synsvolmaaktheid in die rigting van absolute afwesigheid van syn. Hierdie synshiërargie is volgens die vorm-materieskema opgebou. Die materie in die hoëre synslaag word vorm vir die laere, of omgekeerd: die vorm van die laere is die materie vir die hoëre dinge. God is absoluut suiwer vorm of wet (essensie. Die vorme van die dinge is die goddelike wet (genoem exemplar, similitudo, ratio, verbum of imago wat deur God daarin geskape is. God druk op dié wyse sy gelykenis op kreatuur.like wyse uit. Sy absolute volmaaktheid kan alleen tot uitdrukking gebring word deur 'n veelheid en verskeidenheid van geskape dinge. God word deur Thomas die causa effiaiens en exemplaris genoem. Die verhouding tussen Skepper en geskape werklikheid is dus dié van oorsaak en gevolg. As gevolg van sy wetsidee word daar deur Thomas dus nie duidelik tussen Skepper en skepping onderskei nie, want skepping beteken volgens hom onder andere dat God iets goddeliks (die wet in die dinge lê. Via die goddelike wet in die dinge ingeskape, is daar 'n sekere kontinuiteit tussen God en kosmos.

  20. 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...... of a centreline hole in a single compression operation. Friction is also taken into account. The numerical analysis indicates that a lower die angle of approximately 140o results in the largest centreline hole closure for a wide range of material hardening. The value of optimum die angle is not influenced...... by friction, which was found only to change the degree of centreline porosity closure in case of small lower die angle....

  1. Statues Also Die

    Directory of Open Access Journals (Sweden)

    Pierre-Philippe Fraiture

    2016-10-01

    Full Text Available “African thinking,” “African thought,” and “African philosophy.” These phrases are often used indiscriminately to refer to intellectual activities in and/or about Africa. This large field, which sits at the crossroads between analytic philosophy, continental thought, political philosophy and even linguistics is apparently limitless in its ability to submit the object “Africa” to a multiplicity of disciplinary approaches. This absence of limits has far-reaching historical origins. Indeed it needs to be understood as a legacy of the period leading to African independence and to the context in which African philosophy emerged not so much as a discipline as a point of departure to think colonial strictures and the constraints of colonial modes of thinking. That the first (self-appointed exponents of African philosophy were Westerners speaks volumes. Placide Tempels but also some of his predecessors such as Paul Radin (Primitive Man as Philosopher, 1927 and Vernon Brelsford (Primitive Philosophy, 1935 were the first scholars to envisage this extension of philosophy into the realm of the African “primitive.” The material explored in this article – Statues Also Die (Marker, Resnais, and Cloquet, Bantu Philosophy (Tempels, The Cultural Unity of Negro Africa (Cheikh Anta Diop, and It For Others (Duncan Campbell - resonates with this initial gesture but also with the ambition on part of African philosophers such as VY Mudimbe to challenge the limits of a discipline shaped by late colonialism and then subsequently recaptured by ethnophilosophers. Statues Also Die is thus used here as a text to appraise the limitations of African philosophy at an early stage.  The term “stage,” however, is purely arbitrary and the work of African philosophers has since the 1950s often been absorbed by an effort to retrieve African philosophizing practices before, or away from, the colonial matrix. This activity has gained momentum and has been

  2. Die Presbiter by Lukas en Paulus

    Directory of Open Access Journals (Sweden)

    L. Floor

    1976-06-01

    Full Text Available In die jongste navorsing oor Lukas word die skrywer van die derde evangelieverhaal en die Handelinge van die Apostels aan ons bekend gestel as ’n teoloog wat uit die ‘Sitz im Leben’ (uit die situasie van sy eie tyd die boodskap aangaande Christus interpreteer . Lukas sou hom by sy interpretasie van die Christusboodskap laat lei het deur ’n bepaalde dogmatiese ‘Verstandnis’ waardeur hy homself verraai as ’n teoloog van die na-apostoliese tyd.

  3. Adapt or die?

    Science.gov (United States)

    Visser, S S; Nel, A H

    1996-12-01

    The worldwide economic recession and the concomitant limited stock of finances have had an influence on the available money of every household and have also inhibited the improvement of socio-economic conditions and medicine. The Reconstruction and Development Programme (RDP) has the objective of improving the living conditions of the people with regard to housing, education, training and health care. The latter seems to be a major problem which has to be addressed with the emphasis on the preventive and promotional aspects of health care. A comprehensive health care system did not come into being property in the past because of the maldistribution of health care services, personnel and differences in culture and health care beliefs and values. The question that now arises, is how to render a quality health care service within the constraints of inadequate financing and resources. A comprehensive literature study has been done with reference to quality health care and financing followed by a survey of existing health services and finances. Recommendations are made about minimum requirements to be accepted if one were to adapt rather than die in terms of the provision of healthcare: the decentralization and rationalization of the administration of health care, the stress on and realization of effective and efficient primary health care, the acceptance of participative management in health providing organizations, the provision of financial management training for health care managers and the application of management accounting principles for the improvement of the efficiency and effectiveness of management.

  4. Die etiek van Karl Barth

    Directory of Open Access Journals (Sweden)

    J. H. van Wyk

    1986-06-01

    Full Text Available Die etiek van Barth kan nie reg verstaan word sonder begrip van sy ganse teologiese agtergrond en opset, en ek wil byvoeg: sonder die besondere tydsomstandighede (oorlog! waarin hy geleef en gewerk het nie. Dit is verder bekend dat in sy teologiese ontwikkeling verskillende figure groot invloed op hom uitgeoefen het.

  5. Die Parlamentswahlen 2008 in Malaysia

    DEFF Research Database (Denmark)

    Reher, Stefanie; Knirsch, Thomas

    2008-01-01

    Nach den Parlamentswahlen vom März 2008 in Malaysia deutet manches auf einen politischen Umbruch hin: Die regierende Barisan Nasional (BN), die sich bislang einer komfortablen Zweidrittelmehrheit von 91,4 Prozent der Sitze im Parlament des Landes erfreut hatte, rutschte auf 63,1 Prozent ab und das...

  6. Twelve Theses on Reactive Rules for the Web

    OpenAIRE

    Bry, François; Eckert, Michael

    2007-01-01

    Reactivity, the ability to detect and react to events, is an essential functionality in many information systems. In particular, Web systems such as online marketplaces, adaptive (e.g., recommender) sys- tems, and Web services, react to events such as Web page updates or data posted to a server. This article investigates issues of relevance in designing high-level programming languages dedicated to reactivity on the Web. It presents twelve theses on features desira...

  7. Leierskapstyl en die lerende organisasie

    Directory of Open Access Journals (Sweden)

    W. G. Victor

    2002-09-01

    Full Text Available Leadership style and the learning organisation. In the present highly competitive environment, it has become increasingly important for organisational leaders to establish a learning organisation. In this study the focus was on the extent of influence that the evolution of organisations, as determined by their relative level of leadership practises (leadership style, has on the establishment of a learning organisation. Opsomming Die daarstel van ’n lerende organisasie deur bedryfsleiers word toenemend belangrik in die hedendaagse hoogskompeterende omgewing. In hierdie studie is gefokus op die mate van beinvloeding wat die evolusie van organisasies, soos deur hul relatiewe vlak van demokratiese leierskapspraktyke (leierskapstyl bepaal, op die daarstelling van’n lerende organisasie het.

  8. Montessori-skole: die ander kant

    Directory of Open Access Journals (Sweden)

    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.

  9. Comparison of cerebral perfusion reserve and collateral circulation in patients with internal carotid artery disease; Die zerebrale Perfusionsreserve in Abhaengigkeit vom Kollateralisierungstyp bei Patienten mit A.-carotis-interna-Stenosen/-Verschluessen

    Energy Technology Data Exchange (ETDEWEB)

    Reiche, W.; Schaefer, R.; Hermes, M. [Abt. fuer Neuroradiologie, Radiologische Klinik der Universitaet des Saarlandes, Homburg/Saar (Germany); Mueller, M. [Neurologische Klinik der Universitaet des Saarlandes, Homburg/Saar (Germany)

    1997-11-01

    The cerebral hemodynamics in patients with carotid disease is influenced by a network of extra- and intracranial collaterals. The purpose of this study was to compare the findings of regional cerebral perfusion reserve (rCPR) with angiographically proven collateral circulation. In 41 patients (28 men, 13 women, age 63{+-}10 years) with angiographically proven carotid stenoses or occlusions (30 stenoses, 11 occlusions) 24 {sup 99m}Tc-HMPAO-SPECT and 25 dynamic Xe-CT investigations were conducted, both before and after acetazolamide stimulation. rCPR was quantified as the ratio (1) of the absolute rCBF values obtained by Xe-CT and (2) of the count density measured by HMPAO-SPECT of the acetazolamide administration. A rCPR of less than 95% in a vascular territory was classified as compromised rCPR. A recent CT examination was available in all cases. According to the angiographic findings the patients could be classified into (1) group A (n=9) with residual carotid perfusion, (2) Group B (n=8) with collateralization via the circle of Willis, and (3) group C (n=24) with leptomeningeal or opthalmic artery collateral circulation. (orig./AJ) [Deutsch] Die zerebrale Haemodynamik bei A.-carotis-interna-(ACI-)Stenosen/-Verschluessen wird von extra- und intrakaniellen Kollateralen beeinflusst. Ziel dieser Studie war es, die Befunde der regionalen zerebralen Perfusionsreserve (rCPR) mit angiographisch nachgewiesenen Kollateralisierungs- und Anastomosierungstypen zu vergleichen. Bei 41 Patienten (28 Maennder, 13 Frauen, Alter 63{+-}10 Jahre) mit angiographisch untersuchten ACl-Stenosen/-Verschluessen (30 Stenosen, 11 Verschluesse) wurden in 24 Faellen eine {sup 99m}Tc-HMPAO-SPECT und in 25 eine dynamische Xe-CT jeweils vor und nach Diamox{sup R}-Stimulation durchgefuehrt. Fuer die rCPR-Quantifizierung wurde in der Xe-CT das Verhaeltnis der absoluten rCBF-Werte und in der HMPAO-SPECT der Zaehlratendichten jeweils nach zu vor Diamox berechnet. Eine rCPR<95% in einem zerebralen

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Measurement of thyrotropin receptor antibodies (TRAK) with a second generation assay in patients with Graves' disease; Die Bestimmung von Thyreotropin-Rezeptor-Antikoerpern (TRAK) mit einem Assay der zweiten Generation bei Patienten mit Morbus Basedow

    Energy Technology Data Exchange (ETDEWEB)

    Zoephel, K.; Wunderlich, G.; Franke, W.G. [Klinik und Poliklinik fuer Nuklearmedizin, Technische Univ. Dresden (Germany); Koch, R. [Inst. fuer Medizinische Informatik und Biometrie, Technische Univ. Dresden (Germany)

    2000-06-01

    Aim: The detection of TSH-receptor-antibodies (TRAb) in patients (pts) with Graves' disease (GD) is routinely used in nuclear medicine laboratories. It is performed by commercial, porcine radioreceptorassays (RRA) measuring TSH binding inhibitory activity. A second generation assay using the human, recombinant TSH-receptor was developed during the last years. The manufacturer composed this new assay as a coated tube RRA (CT RRA) and claimed a higher sensitivity for GD. Methods: TRAb was measured in 207 pts with various thyroid disorders and 205 healthy controls using the new coated tube RRA (Fa. B.R.A.H.M.S. Diagnostica GmbH, Berlin, Germany) as well as a conventional RRA (Fa. Medipan Diagnostica GmbH, Selchow, Germany): 60 pts suffering from GD showing a relapse after anti-thyroid drug treatment and before radioiodine therapy, 109 pts with disseminated autonomia (DA) and 38 pts suffering from Hashimoto's thyroiditis. A ROC-analysis was performed to find the optimal decision threshold level for positivity. Results: We found 42/60 TRAb-positive pts with GD in the established RRA (threshold 6 U/L) and 52/60 in the CT RRA, respectively. The sensitivity increased from 70% (RRA) to 86,7% (CT RRA). The CT RRA found 2 false positives (one Hashimoto's and one healthy control) and the RRA detected 3 Hashimoto's and 2 healthy controls as false positive. Conclusion: The increased sensitivity of CT RRA for GD provides an advantage compared to conventional RRA, especially in GD-patients relapsing afte antithyroid drug treatment. Functional sensitivity and Interassayvariation of CT RRA are very precisely compared to conventional RRA. Handling of the new assay is also improved. (orig.) [German] Ziel: Die Bestimmung der TSH-Rezeptorantikoerper (TRAK) bei Patienten mit Morbus Basedow ist fester Bestandteil der nuklearmedizinischen In-vitro-Diagnostik. Seit kurzem ist die Bestimmung mit einem TRAK-Assay moeglich, bei dem im Gegensatz zu den herkoemmlichen

  12. Die rym in Jukstaposisie (T.T. Cloete en die regverdiging van enkele fonologiese begrippe

    Directory of Open Access Journals (Sweden)

    D. P. Wissing

    1984-05-01

    Full Text Available Die taalkundige hon daarvan om te kan se dat die goeie literator sonder taalkundige insigte geen volledige cn behoorlike teksanalise kan docn nie. Maar die situasic kan ook omgekeerd wees: die letterkunde (eintlik die woordkunswerk kan ook vir die taalkunde van waarde wees. In hierdie stuk wil ek meer in die besonder probeer aantoon dat en hoe die taalkundige ook ondersteuning vir die invoering van bepaalde fonologiese begrippe uit die gedig kan vind. Vir die doel beperk ek my tot die bunde Jukstaposisie van T.T. Cloete.

  13. Ekumeniese kerkreg: Die aangewese weg?

    Directory of Open Access Journals (Sweden)

    Pieter J. Strauss

    2013-11-01

    Full Text Available Die argument word gehoor dat kerkregeringstelsels soos dié van die Rooms-Katolieke, Lutherse en gereformeerde kerke van ’n transendentale aard was en is. Daardeur word geïmpliseer dat hierdie stelsels een transendentale, unieke vaste beginsel gebruik om ’n hele stelsel van kerkregering van buite af te bepaal. Volgens Leo Koffeman, ’n voorstander van ’n ekumeniese kerkreg, plaas hierdie stelsels hulself hiermee buite die diskoers oor kerkreg en kerkregering en die beweging van die Heilige Gees. ’n Ekumeniese kerkreg, daarenteen, is ten gunste van ’n gemeenskaplike kerkreg tussen kerke. Omdat dit verskillende tradisies bymekaar bring, is dit ’n kritiese en daarom beter benadering. Die skrywer oorweeg hierdie argumente krities in die lig van ’n gereformeerde benadering tot kerkreg.The argument is used that church political systems like that of the Roman Catholic, Lutheran and reformed churches were of a transcendental character. By that it is implied that it used one transcendental and unique ‘hard principle’ from outside to direct a system of church government. Such uniqueness, according to Leo Koffeman who advocates an ecumenical church polity, places it outside the church political discourse and the way of the Holy Spirit. An ecumenical church polity seeks a combined polity between churches and is, by bringing different traditions together, a critical and therefore better undertaking. The author examines these arguments critically in the light of a reformed church polity.

  14. Inequity in the provision of and access to palliative care for cancer patients. Results from the Italian survey of the dying of cancer (ISDOC

    Directory of Open Access Journals (Sweden)

    Costantini Massimo

    2007-04-01

    Full Text Available Abstract Background The palliative services and programs have been developed with different intensity and modalities in all countries. Several studies have reported that a geographic variation in the availability and provision of palliative care services between and within countries exists, and that a number of vulnerable groups are excluded from these services. This survey estimates the distribution of places of care for Italian cancer patients during the last three months of their lives, the proportion receiving palliative care support at home and in hospital, and the factors associated with the referral to palliative care services. Methods This is a mortality follow-back survey of 2,000 cancer deaths identified with a 2-stage probability sample, representative of the whole country. Information on patients' experience was gathered from the non-professional caregiver through an interview, using an adapted version of the VOICES questionnaire. A section of the interview concerned the places of care and the palliative care services provided to patients. Multivariate logistic regression analyses were conducted to identify the determinants of palliative care service use. Results Valid interviews were obtained for 67% of the identified caregivers (n = 1,271. Most Italian cancer patients were cared for at home (91% or in hospital (63%, but with substantial differences within the country. Only 14% of Italian cancer patients cared for at home against 20% of those admitted to hospital, received palliative care support. The principal determinants identified for receiving these service were: an extended interval between diagnosis and death (P = 0.01 and the caregiver's high educational level (P = 0.01 for patients at home; the low patient's age (P Conclusion In Italy palliative care services are not equally available across the country. Moreover, access to the palliative care services is strongly associated with socio demographic characteristics of the

  15. 'n Begronde bedieningsmodel vir die diakonia van die gemeente

    African Journals Online (AJOL)

    15 Feb 2012 ... This work is licensed under the ... Grobler & Van der Walt 2008; Lingenfelter 2005; Armour & Browning 2000) en daarmee saam die ...... missionary structure of the church', Swedish Missiological Themes 93(3), 433–447.

  16. Die Valenz als textgrammatische Kategorie

    Directory of Open Access Journals (Sweden)

    Stojan Bračič

    1994-12-01

    Full Text Available Vor mehr als dreißig Jahren kam der französische Linguist Lucien Tesnière auf die geniale Idee, die gegenseitigen Relationen zwischen dem Verb eines Satzes einerseits und den anderen Satzteilen andererseits mit den chemischen Relationen in der Struktur eines Moleküls zu vergleichen. Die Eigenschaft des Verbs, andere Wörter an sich zu binden, nannte er Verbvalenz. Tesnière schreibt (schon 1959 wörtlich: "Man kann das Verb mit einem Atom vergleichen, an dem Häkchen angebracht sind, so daß es -je nach der Anzahl der Häkchen - eine wechselnde Zahl von Aktanten an sich ziehen und in Abhängigkeit halten kann. Die Anzahl der Häkchen, die ein Verb aufweist, und dementsprechend die Zahl der Aktanten, die es regieren kann, ergibt das, was man die Valenz des Verbs nennt" (Tesnière 1980: 161. Und weiter: "Aufgrund der strukturalen Konnexionen bestehen Dependenzbeziehungen (Abhängigkeitsbeziehungen zwischen den Wörtem. Jede Konnexion verbindet im Prinzip einen übergeordneten mit einem untergeordneten Term" (ibid., 27. Schematisch hat Tesnière diese Relationen bekannt­ lich in den sogenannten Stemmata (Strukturbaumen, graphischen Darstellungen von Konnexionsstrukturen; ibid., 384 wiedergegeben. Im Satz "Mon vieil ami chante cette chanson fort jolie" ist das Verb "chante" als "régissant" allen anderen Wortkonstituenten iibergeordnet, wobei die üntergeordneten Elemente "ami" und "chanson" in einer zweiten Rangstufe wiederum den untergeordneten Elementen "mon", "vieil", "cette", "jolie" übergeordnet sind. (Vgl. Greule 1982: 99.

  17. Die Dankesrede bei der Preisverleihung

    Directory of Open Access Journals (Sweden)

    Elenmari Pletikos Olof

    2012-12-01

    Full Text Available Festliche Preisverleihungen sind Gelegenheiten, bei denen von den Preisträgerneine kurze Rede erwartet wird. Obwohl die Dankesrede eine kleinere Randgattung innerhalb des epideiktischen Genres ist, steht sie im Mittelpunkt des Ereignisses. Rhetorikhandbücher geben zahlreiche Ratschläge, wie eine gute Festrede vorbereitet werden soll, um zu unterhalten, zu bewegen und zu belehren. Ziel dieser Untersuchung ist es festzustellen, welche Eigenschaften der Dankesrede die Zuhörer als erwünscht oder unerwünscht wahrnehmen und welche Charakteristika am meisten zur Qualität festlicher Dankesreden beitragen. Das Korpus der gesprochenen Texte bilden 30 Dankesreden anlässlich kroatischer Preisverleihungen in den Bereichen Schauspiel, Sport, Musik, Fernsehen, Literatur und Wirtschaft. Die Audio-Aufnahmen der Dankesreden wurden einer Gruppe von Hörern zur Bewertung in folgenden Kategorien vorgelegt: interessant, geistreich, hoher Sprachstil, feierlich, emotiv, persönlich, originell, bescheiden, vorbereitet und spontan. Zusätzlich wurde zu jeder Rede die offene Frage gestellt, was dem Zuhörer an der Rede gefallen oder nicht gefallen habe. Die Resultate der Perzeptionsanalye lassen erkennen, dass die Interessantheit einer Rede mit der Eigenschaft des Geistreichen, des Originellen, des Emotionalen und des Persönlichen in Verbindung gebracht wird und die Eigenschaft des Festlichen im Wesentlichen nur mit dem hohen Sprachstil und der Vorbereitetheit des Textes korreliert. Einige Eigenschaften können sowohl erwünscht als auch unerwünscht sein, z. B. Dialekt, Persönliches und Kürze. Die besten Dankesreden haben Eigenschaften, die im Grunde schwer miteinander zu verbinden sind: Einerseits soll der Text vorbereitet sein (hoher Stil, Wortwahl, Figuren, Originalität der Geschichte, Humor, andererseits wird bei der Ausführung Spontaneität (Aufrichtigkeit, Emotionalität, Persönlichkeit erwartet.

  18. Die wêreld en ons

    Directory of Open Access Journals (Sweden)

    D. W. Kruger

    1950-03-01

    Full Text Available Gedurende die jaar 1949 het Sowjet-Rusland twee groot suksesse behaal, n.l. die oorwinning van die Komniunisnie in China en die vervaardiging van die atoombom, albei gebeurtenisse wat vir sy westerse teenstanders ’n groot ontngtering was.

  19. Ueber die Neoperla-Arten aus Java

    NARCIS (Netherlands)

    Klapálek, Fr.

    1910-01-01

    Die Anregung zum Versuche die bisher aus Java bekannten Neoperla-Arten zusammenzustellen, gab mir die Sendung des Herrn E. Jacobson aus Semarang. Sie enthielt zwei Arten, von welchen die eine für mich neu war; ich nehme mir die Freiheit dieselbe ihrem Entdecker zu widmen. Bei dieser Gelegenheit habe

  20. Vraagstelling vir bemagtiging: die tradisionele klaskamer as ...

    African Journals Online (AJOL)

    Erna Kinsey

    ... loep geneem aan die hand van kwalitatiewe data wat tydens 'n empiriese studie op die voor- .... stelling in die klas opgelei, wat die hantering van die leerders se ant- ..... tent, but as part of the meta-communication in the classroom. Reasons.

  1. Afrika die Onbekende: Die Federasie van Rhodesie Njassaland (I

    Directory of Open Access Journals (Sweden)

    J. S. van der Merwe

    1960-03-01

    Full Text Available Die grondgebied van die Federasie van Rhodesië en Njassaland strek oor 14° 15’ in ’n N.-S.-rigting (vanaf22“ 30’ S. to t 8° 15’ S. en ongeveervanaf 22° 0 to t 36° 0. Dit verteenwoordig afstande in albei gevalle van tussen 900 en 1000 myl.

  2. Die Bibliothek ohne Bibliothekar? Zur Situation der Patientenbüchereien in Wien / The Library without a Librarian? The Situation of the Patient Libraries in Vienna

    Directory of Open Access Journals (Sweden)

    Jany, Elke

    2005-12-01

    Full Text Available Libraries for patients fulfil apart from health-specific tasks politico-cultural functions too. However, substantial savings in the health service sector affect also these institutions vital for the recovery of patients. The present work offers an overview on the libraries in the Viennese hospitals with respect to new tasks and challenges that librarians must face; and it demonstrates the different conditions for private as well as public hospitals.

  3. Decorative pleats; Falten, die schmuecken

    Energy Technology Data Exchange (ETDEWEB)

    Marfurt, P. [Sulzer Rueti AG, Rueti (Switzerland)

    1998-06-01

    Pleated fabrics - also known as plisses - are very popular in the fashion industry. The pleats are normally created in a process which involves pressing and heat-setting. The Sulzer Ruti G6200 rapier weaving machine is now available with special equipment, which allows the pleats to be woven directly into the fabric. (orig.) [Deutsch] Im modischen Bereich sind Faltengewebe - sogenannte Plissees - sehr beliebt. Ueblicherweise entstehen die Falten in einem Press- und Thermofixiervorgang. Die Greiferwebmaschine G6200 von Sulzer Rueti ist jetzt mit einer speziellen Ausruestung lieferbar, mit deren Hilfe die Falten direkt in den Stoff gewebt werden koennen. (orig.)

  4. A medical oncologist's perspective on communication skills and burnout syndrome with psycho-oncological approach (to die with each patient one more time: the fate of the oncologists).

    Science.gov (United States)

    Tanriverdi, Ozgur

    2013-06-01

    The increasing incidence of cancer is at the same time one of the leading causes of death all over the world. Many clinical studies show that the psychological disorders are more frequent in cancer patients than the normal population. That is the reason why "psycho-oncology" is getting popular each day. On the other hand, clinical studies about psychological status of the oncologists who are in contact with cancer patients ceaselessly and who are mostly responsible to give the "bad news" to the cancer patients are very limited. In fact, if the clinical studies which show that the frequency of depression and burnout syndrome are increasing among physicians are taken into consideration, one can say that psycho-oncology must cover all the medical personnel who are dealing with cancer patients. It is determined that the rate of depression and burnout syndrome is high among oncologists when referred to the literature. Several solutions are proposed for the psychological conditions of the oncologists and other related personnel who empathize with the patients and deliver "bad news" and also try to adopt ideal "patient-physician" communication model. The knowledge on the psychological conditions of oncology professionals and their behaviour and the results of the clinical studies on this subject will be discussed and the personal opinion will also be presented in this paper.

  5. 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.

  6. Die rol van persoonlikheidstrekke in die weerstand teen stres

    Directory of Open Access Journals (Sweden)

    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.

  7. 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...

  8. Die plek van goud in die huidige internasionale monetêre stelsel en die rol wat dit kan speel in die herstel van die internasionale monetêre orde.

    Directory of Open Access Journals (Sweden)

    D. P. Erasmus

    1964-03-01

    Full Text Available Die vrye wêreld het sedert die oorloggedwonge opskorting van die goudstandaard in 1914, ’n groot agteruitgang in die internasionale betalingsmeganisme beleef. Hoewel die inter- nasionale goudstandaard in die laaste helfte van die twintiger- jare herstel is, was meeste lande nie langer gedwee om hulle aan die monetêre dissipline van dié stelsel te onderwerp nie en vind ons dat die een land na die ander onder die druk van die depressie in die dertigerjare die goudstandaard laat vaar het. Die Verenigde State van Amerika was die enigste uitson- dering. Geleidelik moes wisselkoersstabiliteit en die vrye inter­ nasionale betalingsverkeer vir wisselkoersmanipulasie en valu- tabeheer plek maak. Hierdie transformasie was ’n weerspieë- ling van die sterker opkoms van ekonomiese nasionalisme en die begeerte van die onderskeie lande om elkeen vir homself die beste voordeel in die internasionale ekonomiese en finan- siële terrein toe te eien. Die daarstelling van die Internasionale Monetêre Fonds te Bretton Woods in 1944, was ’n simptoom van die wêreldwye kommer oor die vooroorlogse neigings op monetêre gebied en terselfdertyd ’n poging om meer dissi­ pline in die internasionale betalingsverkeer te skep. Feit is egter dat ondanks sy positiewe resultate op sommige gebiede, die Internasionale Monetêre Fonds nie heeltemal 'n geskikte substituut vir die goudstandaard daargestel het nie. Wat meer is, die skok van die internasionale monetêre steurnisse word nog steeds deur die lande met die internasionale geldeenhede, naamlik die pond sterling en die dollar ondervind.

  9. Die verbond - van Ou Testament na Nuwe Testament

    Directory of Open Access Journals (Sweden)

    H. F. van Rooy

    1983-06-01

    Full Text Available Die verbondsbegrip het in die Ou Testamentiese wetenskap weer ’n plek gekry op grond van die werk van Eichrodt en die studie van ooreenkomste tussen die verbond in die Ou Testament en die buite-Bybelse staatsverdrae, sedert die werk van Korosec,Mendenhall en baie ander. Natuurlik bestaan hieroor nie eenstemmigheid nie, veral omdat oor die ouderdom van die verbondsgedagte in die Ou Testament nie eenstemmigheid bestaan onder geleerdes nie. Die studie van die verbond in die Nuwe Testament het egter nie naastenby dieselfde aandag gekry nie - iets wat miskien as een van die redes vir die ontkenning van die waarde van die verbond vir Nuwe Testamentiese gelowiges beskou kan word. In hierdie studie word drie sake aangeraak, nl. die terminologie vir verbond in die Ou en Nuwe Testament, die agtergrond vir en belangrikste vorme van die verbond in die Ou Testament en enkele opmerkings oor die verbond in die Nuwe Testament.

  10. Verlossing en die verbeelding van die kinderjare: Dickens se voorstelling van kinders in A Christmas Carol

    Directory of Open Access Journals (Sweden)

    David E. Robinson

    2016-03-01

    Full Text Available Hierdie artikel oorweeg die uitbeelding van kinders in Dickens se bekendste Kersboek. Sentraal in hierdie staan die oorweging van die historiese omstandighede waarin hierdie boek geskryf is, asook Dickens se eie kinderjare en die moontlikheid van verlossing, deur die mag van die verbeelding, uit die negatiewe gevolge van sosiale omstandighede en persoonlike keuses. Die veranderende opvatting van die Victoriaanse kind, van die idee dat kinders van nature sondig is tot die idee dat hulle suiwer en onskuldig is, plaas hierdie literêre werk histories en teoreties. Die rol van Dickens se herinneringe aan sy kinderdae en die invloed daarvan op sy werk word bespreek. Die werk van Edmund Wilson en die kenner van kinderliteratuur, Adrienne Gavin, word ingesluit in hierdie oorweging van die kort roman.

  11. Die Last mit der Lust

    Directory of Open Access Journals (Sweden)

    Lutz Sauerteig

    2004-03-01

    Full Text Available Robert Jütte legt mit Lust ohne Last eine umfassende, allgemeinverständliche und spannend zu lesende Geschichte der Empfängnisverhütung von der Antike bis in die unmittelbare Gegenwart vor.

  12. Nuwe patogene in die voedselbedryf

    Directory of Open Access Journals (Sweden)

    M. M. Ehlers

    1996-07-01

    Full Text Available ’n “Nuwe generasie” voedselpatogene het die afgelope jare hul verskyning gemaak en kan 'n ernstige gevaar vir die voedselbedryf inhou. Hierdie organismes is uiters aanpasbaar en bestaande voedselprosesseringstegnieke, veral die verkoeling van voedsel, is nie altyd volkome effektief om hul groei te voorkom nie. Clostridium botulinum tipe E, enterotoksigeniese Eschsrichia coli. Listeria monocytogenes en Aeromonas hydrophila is in staat om in voedsel by 5 °C te groei. Campylobacter jejuni en Brucella kan weer by 5 °C oorleef en 'n derde groep organismes, naamlik Salmonella, Staphylococcus aureus, Vibrio parahaemolyticus en Vibrio vulnificus kan by temperature tussen 5 °C en 12 °C groei en hul teenwoordigheid is ’n aanduiding dat die koueketting verbreek is.

  13. Comparison of informal caregiver and named nurse assessment of symptoms in elderly patients dying in hospital using the palliative outcome scale.

    Science.gov (United States)

    Dawber, Rebecca; Armour, Kathy; Ferry, Peter; Mukherjee, Bhaskar; Carter, Christopher; Meystre, Chantal

    2016-01-12

    A prospective study of symptom assessments made by a healthcare professional (HCP; named nurse) and an informal caregiver (ICG) compared with that of the patient with a terminal diagnosis. To look at the validity of HCP and ICG as proxies, which symptoms they can reliably assess, and to determine who is the better proxy between HCP and ICG. A total of 50 triads of patient (>65 years) in the terminal phase, ICG and named nurse on medical wards of an acute general hospital. Assessments were made using the patient and caregiver versions of the palliative outcome scale (POS), all taken within a 24 h period. Agreement between patient-rated, ICG-rated and HCP-rated POS and POS for symptoms (POS-S) was measured using weighted-κ statistics. Demographic and clinical data on each group of participants were collected. ICG assessments have higher agreement with those of the patient than HCP. Better agreement in both groups was found for physical symptoms, and best agreement was for pain. The worst agreements were for psychological symptoms, such as anxiety and depression, and for satisfaction with information given. Psychological symptoms are overestimated by both ICG and HCP. ICGs are more reliable proxies than HCPs. A trend for overestimation of symptoms was found in both groups which may lead to undervaluation of the quality of life by proxy and overtreatment of symptoms. This highlights the need to always use the patient report when possible, and to be aware of the potential flaws in proxy assessment. Reasons for overestimation by proxies deserve further research. 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/

  14. Die gesetzliche Frauenquote in Deutschland

    OpenAIRE

    Amling, Svenja

    2011-01-01

    In der vorliegenden Arbeit wird auf eine per Gesetz vorgeschriebene Frauenquote in Deutschland eingegangen. Im Fokus steht die Frage, ob Frauendiskriminierung durch eine solche Vorschrift tatsächlich bekämpft werden kann oder ob vielmehr die Männer diskriminiert würden. Zudem werden mögliche Unterschiede in den Führungsstilen zwischen Frauen und Männern untersucht sowie einige bereits vorhandene Frauenquoten in Politik und Wirtschaft vorgestellt.

  15. Dies irae ~Acta est Fabula~

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    从2007年11月的Diesirae Also sprach Zarathstra到2009年的7月的Dies irae Also sprach Zarathustra—die Wieder kunfl-,Light社的Diesirae的完全版可说是时隔两年的大坑,发行了两个非完全版的游戏吊足玩家们的胃口后。

  16. Gedagtes oor die onbepaaldheidsbeginsel van Heisenberg

    Directory of Open Access Journals (Sweden)

    P. H. Stoker

    1955-03-01

    Full Text Available Van filosofiesc syde en ook deur populariserende skrywers is daar al baie geskryf oor die onbepaaldheidsbeginsel in die Fisika, wat deur Heisenberg in die twintiger jare na vore gebring is.

  17. Videobasierte Unterrichtsbeobachtung: die Quadratur des Zirkels?

    Directory of Open Access Journals (Sweden)

    Regula Fankhauser

    2012-12-01

    Full Text Available Seit einigen Jahren wird Unterrichtsforschung vermehrt videobasiert angegangen. Die methodologische Diskussion, die die Weiterentwicklung des Instrumentariums begleitet, kreist dabei zentral um die Frage der Invasivität der Aufzeichnungstechnik und möglicher Kameraeffekte. Je nach methodologischer Ausrichtung wird diesem Problem anders begegnet: So versucht die abbildtheoretische Unterrichtsvideografie, die Invasivität zu kontrollieren. Qualitative Methoden wie die Kameraethnografie dagegen machen mögliche Kameraeffekte wie die Performanz vor der Kamera oder die Blickrichtung, die durch das Kameraauge fixiert wird, zum Ausgangspunkt neuer, ästhetischer Verfahrensweisen. Der vorliegende Artikel geht einen dritten Weg: Anhand eines Rückgriffs auf den Wissenschaftssoziologen LATOUR und anhand der methodologischen Reflexion eines forschungspraktischen Beispiels sollen grundsätzliche Probleme der Unterrichtsforschung herausgearbeitet werden, die sich mit dem Einsatz der Videografie besonders deutlich zeigen und mit der sich die Unterrichtsforschung vermehrt auseinandersetzen müsste. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1301241

  18. Dying at the best time.

    Science.gov (United States)

    Seale, C; Addington-Hall, J

    1995-03-01

    These are the results of two surveys of relatives, and others who knew people who had died, describing events in the year before death and their views on the time of the person's death. Those surveyed were identified from death certificates in England. The main focus is on a sample of 3696 people dying in 1990 in 20 health authorities, with supporting analysis from an earlier national sample of 639 people dying in 1987. Variation in peoples' views about whether an earlier death would have been better is reported, in the context of debate about euthanasia. Spouses were less likely than others to feel that it would have been better if the person had died earlier, and this held true even when controlling for the deceaseds' levels of pain, distress, dependency and age. Spouses were more likely than others to say that a later death would have been better, though not in cases where the deceased was reported as having said they wanted to die sooner. Spouses were influenced by the loss which the death of the person represented for them, being more likely than others to say they missed the person who died a great deal, and feel loneliness was a big problem. Non spouses (children and other relatives of the deceased, friends, neighbours and a few officials) on the other hand were more likely than spouses to say an earlier death would have been better, even when levels of pain, distress, dependency and age were controlled for.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Uitdagings in die onderrig van evolusie in die lewenswetenskappeklaskamer

    Directory of Open Access Journals (Sweden)

    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

  20. Cuidador familiar do idoso em cuidados paliativos: o processo de morrer no domicílio Family caregiver of elderly patients in palliative care: the process of dying at home

    Directory of Open Access Journals (Sweden)

    Flavia Renata Fratezi

    2011-07-01

    Full Text Available Este estudo teve como objetivos: identificar e analisar o significado do processo de morrer para cuidadores familiares de pacientes idosos em cuidados paliativos. Tratou-se de pesquisa qualitativa com utilização de entrevista. Os dados foram analisados por conteúdo. A presença de doenças crônicas que levam o idoso a necessitar de cuidados paliativos impõe sobre o cuidador familiar sentimentos complexos e ambivalentes. A proximidade e inevitabilidade da morte do idoso colaboram para intensificar esses sentimentos, mas possibilitam ao cuidador resignificar como vivencia essa experiência. Diante desta complexidade, torna-se evidente que a equipe paliativista precisa colaborar junto ao cuidador familiar, no sentido de tentar amenizar essa situação.This study sought to identify and analyze the significance of the process of dying for family caregivers of elderly patients in palliative care. It involved qualitative research with the use of interviews. The data were scrutinized by content analysis. The presence of chronic diseases that lead the elderly patient to require palliative care imposes a series of complex and ambivalent feelings on the family caregiver. The proximity and inevitability of death of the elderly patient exacerbate these feelings, but also lead the caregiver to reconsider how to handle this experience. Given this complexity, it becomes clear that the palliative tem need to work with family caregivers, to try to alleviate this situation.

  1. Die Departement Godsdiens- en Sending- wetenskap (Afd A ...

    African Journals Online (AJOL)

    van die teologiese leergang aan die Transvaalse Universiteitskollege (TUK). Die. ISSN 0259 9422 = m s 4 ... Die Universiteit van Pretoria neem in 1916 'n eerste tree met die onderrig van teo- logie. In die TUK ...... Van Leeuwen, A T 1966.

  2. Kantaantekeninge by die formele en materiële beginsels van die Suid-Afrikaanse kerkgeskiedskrywing

    Directory of Open Access Journals (Sweden)

    E. Brown

    1977-06-01

    Full Text Available Die totstandkoming van ons Kerkhistoriese Werkgemeenskap staan sekerlik in die teken van ’n ‘geschichtliche Bevifusstsein’ met betrekking tot die kerkgeskiedenis in ons land. In die geskiedenis van die ecclesia patria val dit nie sonder rede met die toenemende pleitredes vir ’n krities (teologiese beoefening van hierdie vakgebied saam nie.

  3. 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 ...

  4. Die Literêre Sisteem Van Dertig

    Directory of Open Access Journals (Sweden)

    H. Viljoen

    1984-05-01

    Full Text Available In die literatuurgeskiedenis is daar onteenseglik ’n behoefte aan sistematiek. ’n Vinnige oorsig oor byvoorbeeld die geskiedenis v an die Afrikaanse poesie kan die leser erg verward laat. Daar is verskeie redes daarvoor. Eerstens word verskillende kategorieë gebruik om die verskillende generasies mee te beskryf — as dit al hoegenaamd duidelik is waar die grense tussen generasies nou eintlik lê. Die leser word as belangrike kategorie beskou by die poësie voor 1900, bewuste kunstenaarskap by Dertig, stad en oorlog (tematiese dinge by Veertig. Standaardbegrippe is nodig waarmee verskillende generasies vergelyk kan word.

  5. Die filosofie van Smuts en Boodin.

    Directory of Open Access Journals (Sweden)

    J. M. de Wet

    1936-03-01

    Full Text Available Die werk van generaal Smuts, baie goed bekend omder die titel ,,Holism and Evolution” , en sy artikel oor ,,Some recent scientificadvances in their bearing on philosophy” in ,,Our Changing worldview”, as ook die werke van J. E. Boodin, professor in die wysbegeerteaan die Universiteit van California, Los Angeles, ,,Cosmic Evolution 1925, ,,Three interpretations of the Universe” 1934 en ,,God” 1934, toon die besondere en kenmerkende gedagtegamg vandie filosofie van die laaste tiental jare aan. Die kenmerkende is dit dat dit ’in filosofie is van sintese of, soos Whitehead

  6. Pain management. Theological and ethical principles governing the use of pain relief for dying patients. Task Force on Pain Management, Catholic Health Association.

    Science.gov (United States)

    1993-01-01

    Pain management is a societal problem because of concerns about the use of drugs, the belief that patients are not good judges of the severity of their pain, and an alarming level of ignorance about pain and its treatment among physicians, nurses, and other healthcare providers. The result is that patients suffer pain unnecessarily, even up to the point of their death. Pain management is also a clinical-practice problem. Courses in pain and symptom management are not readily available to medical and nursing students. And in clinical practice, good pain assessment is not easy to accomplish because pain is so subjective. Fortunately, with education, doctors and nurses can vastly improve their ability to assess and manage patients' pain. Additional problems in pain management relate to the manner in which healthcare is provided today: an acute disease-oriented model of hospital care, frequent transfers, fragmented care, inadequate reimbursement, market forces that drive up costs, and maldistribution of clinical services. In improving their ability to manage pain, professionals must understand the difference between pain and suffering, acute and chronic pain, and the sensory and emotional aspects of pain. Guiding principles include Church teaching and ethical principles, such as patient self-determination, holistic care, the principle of beneficence, distributive justice, and the common good. Pain management strategies that will be instrumental in formulating effective responses to these problems include expanding professional and community education, affording pain funding priority, establishing institutional policies and protocols, forming clinical teams, encouraging hospice and home care, and requiring accreditation in pain and symptom management.

  7. Strategieë om die implementering van die Suid-Afrikaanse professionele leergemeenskapmodel te bevorder

    Directory of Open Access Journals (Sweden)

    Christina J. van Staden

    2014-02-01

    Full Text Available Die Geïntegreerde Strategiese Beplanningsraamwerk vir Onderwyseropleiding en -ontwikkeling in Suid-Afrika 2011–2025 vereis dat vakverwante professionele leergemeenskappe tussen 2011 en 2017 op skool- en distriksvlak gevestig word. Die doel daarvan is om onderwysers van geleenthede te voorsien om hul eie leerbehoeftes te identifiseer en te vervul. Slegs sommige van die Distriksonderwysersontwikkelingsentra wat as vergaderplekke moet dien, hoef egter teen 2025 gereed te wees. Die gaping tussen beleid en die implemetering daarvan kan die vestiging van professionele leergemeenskappe rem en selfs verhoed. Drie implementeringsprobleme wat die professionele leergemeenskapmodel op die berugte onderwyshervormingsiklus kan stuur, word geïdentifiseer ten einde strategieë aan die hand te doen om die probleme op te los. Die ondersoek het tot die voorstel gelei dat ’n gekoördineerde benadering noodsaaklik geword het ten einde te verhoed dat die professionele leergemeenskapmodel die prooi van die berugte onderwyshervormingsiklus word.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Reconstruction of mandibular defects in irradiated patients

    Energy Technology Data Exchange (ETDEWEB)

    Klotch, D.W.; Gump, J.; Kuhn, L. (Univ. of South Florida, Tampa (USA))

    1990-10-01

    In this prospective study, mandibular reconstruction using titanium plates was evaluated in 31 patients treated between July 1988 and January 1990. Sixteen patients had prior surgery; 13 had prior radiotherapy. In 11 patients, prior radiation and surgery had failed. Sixteen patients received postoperative radiotherapy either in standard or accelerated fractions. Twelve patients had complications of either intraoral (8), extraoral (5), or combined (1) plate exposure or fistula formation (2). Factors significantly related to complications were poor nutrition, accelerated radiation, and recurrence. Sixty-one percent of all patients healed uneventfully. When patients with complications secondary to recurrence who subsequently died were excluded, the success rate was 73%. Only one patient had an unacceptable result that produced a cosmetic and functional deformity despite secondary repair.

  10. 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.

  11. De-tabooing dying control - a grounded theory study.

    Science.gov (United States)

    Thulesius, Hans O; Scott, Helen; Helgesson, Gert; Lynöe, Niels

    2013-03-13

    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). 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. 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 or PAS, is seen in Europe and North

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

    Science.gov (United States)

    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.

  13. The Decisonal Autonomy Defending the Right to Die With Dignity

    OpenAIRE

    Riva Sobrado de Freitas; Daniela Zilio

    2016-01-01

    This article aims to verify the possibility that the terminal patient, provided with decisional autonomy, can claim the right to die with dignity. To achieve the intent, it was done a bibliographic exploratory-explanatory research, qualitative, using the deductive method. Concluding that, even if the subject is polemic, the decisional autonomy deserves to be considered, including in the execution of the right to die with dignity, since it is intended to safeguard the human being in the most i...

  14. Die Studentverpieegster As Adolessent

    Directory of Open Access Journals (Sweden)

    S.P. Human

    1978-09-01

    Full Text Available The student nurse is no exception to the rule that for an adolescent this stage is a time of uncertainty and is full of problems. Her status in the social hierarchy is an uncertain one: She is neither a child nor an adult and yet her patients are mainly adult. She lives through a stage of change, experiences frustration in the face of demands for conformity. She encounters the problem of self-identification. What is this “ self” that she must learn to recognise and accept? It is important that tutors, ward sisters and matrons should be aware of all this and be competent to help the student nurse through adolescence. She must be able to develop into a mature, responsible,professional member of the community.

  15. Die anderen Ausdrucksweisen: subtile Offensiven

    Directory of Open Access Journals (Sweden)

    Ella Jasiowka

    2002-03-01

    Full Text Available Was passiert, wenn der „Herrscher des filmischen Blickes“ eine Frau ist? Anhand zweier jeweils sehr unterschiedlicher Beispiele „weiblicher“ Filmkunst zeigt die Autorin, dass es nötig ist, herkömmliche Interpretationsmuster zu überwinden, um dem Filmschaffen einzelner Künstler und Künstlerinnen auf den Grund zu gehen. Da es nicht die „feministische Kunst“ an sich gibt, muß man für das Werk so unterschiedlicher Künstlerinnen wie Sally Potter und Jane Campion jeweils unterschiedliche Schlüssel suchen, um ihnen gerecht zu werden. Dies tut Radkiewicz in ihrem Werk – aus feministischer Perspektive. Sie holt jeweils verschieden weit aus, wenn es darum geht, künstlerische Herkunft, Biographie, Vorbilder und Ziele der Künstlerinnen zu deren Werk in Bezug zu setzten. Ohne zu bahnbrechend neuen Erkenntnissen zu kommen, gelingt es ihr doch, ein komplexes Bild der von ihr behandelten Filmemacherinnen und den Filmen zu entwerfen, das einen umfassenden Gesamteindruck vermittelt. Die Kürze des Buches bringt dabei eine Konzentration mit sich, die zu einer Weiterbeschäftigung und Vertiefung einlädt.

  16. MR enterography sequence evaluation for patients with Crohn's disease; Sequenz-Evaluation fuer die MR-Enterografie fuer Patienten mit Morbus Crohn

    Energy Technology Data Exchange (ETDEWEB)

    Schleder, S.; Dendle, L.M.; Friedrich, C.; Wiggermann, P.; Stroszczynski, C.; Schreyer, A.G. [Universitaetsklinikum Regensburg (Germany). Inst. fuer Roentgendiagnostik; Pawlik, M. [Caritas-Krankenhaus St. Josef, Regensburg (Germany). Klinik fuer Anaesthesiologie, Intensiv- und Notfallmedizin; Ott, C. [Universitaetsklinikum Regensburg (Germany). Klinik und Poliklinik fuer Innere Medizin I; Agha, A. [Universitaetsklinikum Regensburg (Germany). Klinik und Poliklinik fuer Chirurgie

    2013-05-15

    Purpose: To evaluate a routine MR enterography (MRE) protocol for patients with Crohn's disease (CD) in order to assess and rank the subjectively most important sequences regarding diagnostic decisions. Materials and Methods: We prospective ly examined 84 patients (42 male) with known CD using a coronal T2/T1-weighted balanced SSFP (TrueFISP), axial T2-weighted single shot TSE (HASTE) as well as an axial T1-weighted gradient-echo sequence (2D-FLASH) before intravenous contrast application and a 2D-FLASH sequence with axial and coronal orientation after in travenous contrast application. 4 experienced radiologists subjectively evaluate d the sequences independently using a scale between 1 and 5 (1 = excellent; 5 = non-diagnostic) regarding their diagnostic significance for a final radiologic d ecision. The ranking of the different sequences was statistically tested by the Friedman analysis. Results: The following ranking was found: HASTE sequences wer e ranked prior to contrast-enhanced axial gradient-echo (2D-FLASH). The third to fifth ranking was TrueFISP, the axial contrast-enhanced 2D-FLASH and the 2D-FLA SH without contrast, respectively. Differences between the first and second rank were significant (p < 0.05), and all other differences were highly significant (p < 0.01). Conclusion: The stable and fast T2-weighted MR sequences without intravenous contrast represented by axial HASTE and coronal TrueFISP were ranked as number 1 and 3. The examination protocol should be completed by a coronal T 1-weighted gradient-echo-sequence after contrast injection, which can be supplemented by an axial acquisition. The T1-weighted gradient-echo sequence without contrast could be omitted. (orig.)

  17. Twelve tips for teaching medical students with dyslexia.

    Science.gov (United States)

    Shaw, Sebastian Charles Keith; Anderson, John Leeds

    2017-07-01

    Dyslexia is a common learning difficulty. As a result of SS' own experiences as a medical student with dyslexia, we have been researching and teaching on this topic for the past two years. Here, we present twelve tips for teaching medical students with dyslexia. These are gathered from our personal experiences and research, discussions with other educators, and wider literature on the topic. This article aims to shed some light on dyslexia, and also to make practical suggestions. Teaching students with dyslexia should not be a daunting experience. Small changes to existing methods, at minor effort, can make a difference - for example, adding pastel colors to slide backgrounds or avoiding Serif fonts. These tips can help educators gain more insight into dyslexia and incorporate small, beneficial adaptations into their teaching.

  18. Antibacterial activities of extracts from twelve Centaurea species from Turkey

    Directory of Open Access Journals (Sweden)

    Tekeli Yener

    2011-01-01

    Full Text Available Members of the genus Centaurea (Asteraceae have been used in traditional plant-based medicine. The methanol extracts of twelve Centaurea species, of which five are endemic to Turkey flora, were screened for antibacterial activity against four bacteria (Escherichia coli, Bacillus cereus, Salmonella enteritidis, Staphylococcus aureus. The antibacterial activity was evaluated by the microdilution method and the minimum inhibition concentrations (MIC of the extracts were determined. C. cariensis subsp. microlepis exhibited an antimicrobial effect on all tested microorganisms. The extracts from eight Centaurea species (C. balsamita, C. calolepis, C. cariensis subsp. maculiceps, C. cariensis subsp. microlepis, C. kotschyi var. kotschyi, C. solstitialis subsp. solstitialis, C. urvillei subsp. urvillei and C. virgata possessed antibacterial activity against several of the tested microorganisms.

  19. Twelve tips on how to compile a medical educator's portfolio.

    Science.gov (United States)

    Dalton, Claudia Lucy; Wilson, Anthony; Agius, Steven

    2017-09-17

    Medical education is an expanding area of specialist interest for medical professionals. Whilst most doctors will be familiar with the compilation of clinical portfolios for scrutiny of their clinical practice and provision of public accountability, teaching portfolios used specifically to gather and demonstrate medical education activity remain uncommon in many non-academic settings. For aspiring and early career medical educators in particular, their value should not be underestimated. Such a medical educator's portfolio (MEP) is a unique compendium of evidence that is invaluable for appraisal, revalidation, and promotion. It can stimulate and provide direction for professional development, and is a rich source for personal reflection and learning. We recommend that all new and aspiring medical educators prepare an MEP, and suggest twelve tips on how to skillfully compile one.

  20. Spectroscopy of twelve Type Ia supernovae at intermediate redshift

    CERN Document Server

    Balland, C; Pain, R; Walton, N A; Amanullah, R; Astier, Pierre; Ellis, Richard S; Fabbro, S; Goobar, A; Hardin, D; Hook, I M; Irwin, M J; McMahon, R M; Mendez, J M; Ruiz-Lapuente, P; Sainton, G; Schahmaneche, K; Stanishev, V

    2005-01-01

    We present spectra of twelve Type Ia supernovae obtained in 1999 at the William Herschel Telescope and the Nordic Optical Telescope during a search for Type Ia supernovae (SN Ia) at intermediate redshift. The spectra range from z=0.178 to z=0.493, including five high signal-to-noise ratio SN Ia spectra in the still largely unexplored range 0.15 < z < 0.3. Most of the spectra were obtained before or around restframe B-band maximum light. None of them shows the peculiar spectral features found in low-redshift over- or under-luminous SN Ia. Expansion velocities of characteristic spectral absorption features such as SiII at 6355 angs., SII at 5640 angs. and CaII at 3945 angs. are found consistent with their low-z SN Ia counterparts.

  1. Tweedimensionele generatorfunksie vir die vektorkardiogram vir gebruik in volume-geleidingsmodelle van die toraks

    Directory of Open Access Journals (Sweden)

    T. A. Geldenhuys

    2006-09-01

    Full Text Available ’n Elektrokardiogram (EKG meet die elektriese aktiwiteit van die hart op die veloppervlak. Volumegeleidingsmodelle van die toraks kan ontwerp word om hierdie metings te simuleer. ’n Generatorfunksie, wat die elektriese aktiwiteit van die hart beskryf, word benodig om hierdie simulasies aan te dryf. Hoewel soortgelyke simulasies van variërende kompleksiteit in die literatuur bespreek word, is daar ’n behoefte aan ’n vereenvoudigde, dog omvattende benadering wat kan dien as inleiding tot die onderwerp of vir gevalle waar ’n eerste-orde-benadering tot die probleem voldoende is. In hierdie artikel word ’n oorsig gegee oor die vektorinterpretasie van die EKG, ook bekend as ’n vektorkardiogram (VKG, in die tweedimensionele menslike frontale vlak. Die afleiding van die ekwivalente elektriese dipool (met ander woorde die kardiale vektor vanaf die VKG, wat gebruik kan word as ’n stroombron-generatorfunksie vir volumegeleidingsmodelle wat die EKG simuleer, word bespreek. ’n Prosedure om so ’n volume-geleidingsmodel met die eindige-element-tegniek te implementeer en die vereenvoudigde tweedimensionele generatorfunksie te gebruik, sowel as die resultate daarvan, word bespreek. Die algemene kenmerke van gemete EKG-afleidings stem ooreen met dié wat deur die eenvoudige model voorspel word.

  2. Die Meting van die verband tussen geslag en konformiteit as groepdinamiese veranderlikes.

    Directory of Open Access Journals (Sweden)

    W. S. de Villiers

    1982-11-01

    Full Text Available The amount and kind of conformity induced by group pressure depend upon the nature of the situation. The nature of the group and the characteristics of the individual. In this particular study the experimental measurement of conformity developed by Asch and Crutchfield was repeated. Confirmation was found that sex operates as one of the determinants of conformity. OpsommingIn die sosiale bedryfsielkunde is die invloed van die groep op die individu een van die vernaamste studieterreine. Die mate waarin ‘n individu konformeer tot groepsdruk hang af van die aard van die situasie, die aard van die groep en die eienskappe van die individu. In hierdie studie is die eksperimentele meting van konformiteit soos ontwikkel deur Asch en Crutchfield herhaal en bevestiging is gevind dat geslag een van die individuele determinante van konformiteit is.

  3. Living through the end: The phenomenon of dying at home.

    Science.gov (United States)

    Solomon, Diane N; Hansen, Lissi

    2015-04-01

    To explore the unique lived experiences of one patient who died at home and her family members, and to interpret how dying at home influenced patterns of bereavement for this patient's family. Benner's (1985) interpretive phenomenological approach was employed to get at the embedded nature of the social phenomenon of dying at home, uncovering what may be taken for granted by participants - in this case, during and after the patient's home hospice course. The participants were a 78-year-old female diagnosed with amyotrophic lateral sclerosis six months prior to death, her husband, and three of her four children. In line with the patient's wish to die at home, she voluntarily forewent food and drink when she no longer wished to watch her body deteriorate and felt that her life had run its course. She informed her family of this plan, and all were supportive. For data collection, separate single in-depth interviews were conducted with the deceased three months prior to death, and after death with three of her four children and her spouse of 60 years. For data analysis, the interview transcripts were coded for paradigm cases, exemplars, and themes. The paradigm case, "The Meaning of Being at Home," revealed that for study participants, remaining home with hospice provided a richly familiar, quiet, and safe environment for being together over time and focusing on relationships. Exemplars included "Driving Her Own Course" and "Not Being a Burden." Salient themes encompassed patient and family characteristics, support, emotions, the value of time, and aspects of the healthcare team. End-of-life care providers need to hold a patient-centered, family-focused view to facilitate patient and family wishes to remain home to die. Investigation into family relationships, from the perspectives of both patient and family members, longitudinally, may enrich understanding and ability and help patients to die at home.

  4. Asistencia al paciente agónico que va a fallecer en urgencias Care for the dying patient in emergency departments

    Directory of Open Access Journals (Sweden)

    M.L. Iglesias

    2010-01-01

    Full Text Available La finalidad de este documento es aportar a los profesionales de los servicios de urgencias hospitalarios las herramientas suficientes para afrontar, según la organización y las posibilidades de cada hospital, la llegada de los pacientes en situación de últimos días. Es primordial proporcionar un entorno profesional, técnico y humano basado en conceptos, actitudes y habilidades que permitan afrontar las demandas de confort y los requerimientos emocionales y psicosociales que generan estas situaciones.The aim of this article is to provide professionals in the hospital emergency departments with sufficient tools to face, according to the organisation and possibilities of each hospital, the admission of patients in the final days of life. It is primordial to provide a professional, technical and human environment based on concepts, attitudes and skills that make it possible to deal with the demands of comfort and the emotional and psycho-social requirements generated by these situations.

  5. 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

  6. Leerteoretiese basis van die andragogie

    Directory of Open Access Journals (Sweden)

    C. J. A. Simpson

    1991-06-01

    Full Text Available Learning theory basis of andragogy. A cursory glance at andragogy creates the impression that humanistic learning theory plays an all encompassing role in the learner centered approach andragogy espouses. A closer look, however, reveals that Knowles (1973, after having made an intensive study of learning theory, created an extensive framework within which human resource development can take place. The fact that Knowles attracted critique from different areas, led to a need to ascertain the role different learning theories, if any, played in the emergence of andragogy. Having looked at the assumptions displayed by the andragogical approach, as well as a comparison of different learning theories and their connection with andragogy, it became clear that andragogy contains elements of various learning theories in an adapted way. These adaptations resulted in an approach to adult education in which learners are given the opportunity to be part of the learning process in such a way that they themselves contribute to the development which takes place. Opsomming Met 'n eerste oogopslag wil dit voorkom asof humanistiese leerteorie 'n oorheersende rol in die leerdergesentreerde benadering van andragogie speel. By nadere ondersoek blyk dit egter dat Knowles (1973, na 'n deeglike studie van verskillende leerteoretiese beginsels, 'n omvangryke raamwerk geskep het waarbinne, aan die hand van verskeie aangepaste leerteoretiese beginsels, menslike hulpbronontwikkeling kan plaasvind. As gevolg van die feit dat Knowles vanuit verskillende oorde kritiek op die lyf geloop het, is besluit om die rol wat verskillende leerteorieë in andragogie speel, te bestudeer. Dit blyk dat andragogie nie net elemente van verskillende leerteorieë bevat nie, maar dat toepaslike aspekte van die teoriee wat ondersoek is, benut en aangepas is om 'n geintegreerde benadering te bewerkstellig waarin veral volwassene-leerders by leergeleenthede en hulle selfontwikkeling betrek word.

  7. Die resepsie van die Heidelbergse Kategismus (Sondag 17 en 22 insake die opstanding in die Nederduitse Gereformeerde Kerk sedert 2000 (Deel 2

    Directory of Open Access Journals (Sweden)

    Johannes W. Hofmeyr

    2013-06-01

    Full Text Available Met die 450e herdenking van die Heidelbergse Kategismus as vertrekpunt, word met die huidige en die vorige artikel gepoog om lig te werp op die plek, die rol en die interpretasie van die opstanding van Jesus Christus in veral Sondag 17 en 22, spesifiek in die konteks van twee besondere eras in die Nederduitse Gereformeerde (NG Kerk. In die vorige artikel is allereers ’n bespreking gevoer oor die Heidelbergse Kategismus (HK. Daar is gekyk na die resepsie van die betrokke HK-geloofsartikels in die era van Andrew Murray, spesifiek teen die agtergrond van die negentiende-eeuse liberale teologie in Nederland. In die huidige artikel word soortgelyk gekyk na die resepsie van die betrokke HK-geloofsartikels in die NG Kerk na 2000, teen die agtergrond van die herverskyning van die negentiende-eeuse liberale teologie in die vorm van die Jesus Seminaar, die Nuwe Hervorming en ondersteuners daarvan binne die NG Kerk. Sowel die negentiende-eeuse liberale stryd in die NG Kerk asook die stryd oor die opstanding in die NG Kerk van die eerste dekade van die een-en-twintigste eeu, soos verder in hierdie artikel sal blyk, was gekenmerk deur kontekstueelbepaalde uniekhede. Die gemene deler was dat albei deel was van tye van teologiese vrysinnigheid. In die lig van hierdie bespreking word tot die gevolgtrekking gekom dat die NG Kerk tans, betreffende haar identiteit as gereformeerde kerk waarskynlik in ’n kritieke geloofs- en toekomskrisis verkeer. Dit impliseer kommerwekkende gevolge vir haar Skrifverstaan en getuienis as belydenis en belydende kerk van Jesus Christus en haar toekoms. Alleen duidelike visie, verantwoordelike leierskap en ’n herontdekking van die verlossingskrag van Christus se kruis en opstanding sal herstellende, positiewe en dinamiese oplossings kan bied om sodoende die NG Kerk te red van ’n snelwentelende afwaartse spiraal.With the 450th celebrations of the origin of the Heidelberg Catechism (HC in mind, the main aim of this and the

  8. Die «ASEAN-Wirtschaftsgemeinschaft»

    DEFF Research Database (Denmark)

    Juego, Bonn

    2014-01-01

    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...

  9. Moderne diskoerse in die teologie vandag

    Directory of Open Access Journals (Sweden)

    J.H. van Wyk

    2013-11-01

    Full Text Available In hierdie artikel word aandag gevra vir enkele moderne diskoerse in die teologie vandag. Volgens die outeur staan die vrae oor God, Jesus, die mens en die aarde in die sentrum van belangstelling en oorheers dit in ’n groot mate die teologiese debat. Die opkoms van die moderne aggressiewe ateïsme, die wetenskaplike navorsing oor die historiese Jesus, die groeiende vrae oor die mens en die menslike samelewing, asook die dreigende ekologiese krisis op aarde, sorg vir nuwe debatte van ongekende omvang. Die outeur bespreek hierdie debatte oorsigtelik, met kritiek waar nodig, en sluit af met enkele rigtingwysers van wat hy as ‘goeie teologie’ verstaan.In this article attention is paid to some modern discourses in theology today. According to the author the questions about God, Jesus, man and the earth are in the centre of interest and to a large extent dominate the theological debate. The rise of modern aggressive atheism, the scientific research on the historic Jesus, the growing questions about man and human society as well as the threatening ecological crisis on earth, provide new discourses of unparalleled magnitude. The author provides a broad summary of these discourses, with criticism where necessary, and concludes with some indicators of his view what can be called ‘good theology’.

  10. Die Ökonomik der Reputation

    OpenAIRE

    Tegtmeyer, Jan C.

    2005-01-01

    Gegenstand dieser Arbeit ist die Betrachtung der Reputation eines Unternehmens aus ökonomischer Sicht. Die Zusammenfassung von Beurteilungen der Unternehmensaktivitäten durch wirtschaftlich relevante Interessengruppen bildet eine Unternehmensreputation. Die Reputation wird hier mit einem betriebswirtschaftlichen Kosten-Nutzen Kalkül betrachtet. Nur mit einer Reputation, die durch eine vorteilhafte Beurteilung der Unternehmensleistung entsteht, kann ein Unternehmen wirtschaftliche Vorteile gen...

  11. Die Ökonomik der Reputation

    OpenAIRE

    Tegtmeyer, Jan C.

    2005-01-01

    Gegenstand dieser Arbeit ist die Betrachtung der Reputation eines Unternehmens aus ökonomischer Sicht. Die Zusammenfassung von Beurteilungen der Unternehmensaktivitäten durch wirtschaftlich relevante Interessengruppen bildet eine Unternehmensreputation. Die Reputation wird hier mit einem betriebswirtschaftlichen Kosten-Nutzen Kalkül betrachtet. Nur mit einer Reputation, die durch eine vorteilhafte Beurteilung der Unternehmensleistung entsteht, kann ein Unternehmen wirtschaftliche Vorteile gen...

  12. Die Welt als Fassade : kosmischer Schrecken als Angriff auf die Wirklichkeit

    OpenAIRE

    Zuch, Rainer

    2015-01-01

    "The oldest and strongest emotion of mankind is fear, and the oldest and strongest kind of fear is fear of the unknown." Mit diesem Satz eröffnet Howard Phillips Lovecraft 1927 seinen berühmten Essay "Supernatural Horror in Literature". In der Phantastik wird oft die Demontage der Erfahrungswirklichkeit durch die Kontaminierung mit dem Wunderbaren thematisiert; die bekannte Welt bekommt Risse, durch die das Unbekannte eindringt. Radikalisiert wird dies in Konzepten, die die gesamte vertrau...

  13. How Tycho Brahe really died

    DEFF Research Database (Denmark)

    Jacobsen, Aase Roland; Petersen, Lars

    2001-01-01

    In 2001 we commemorate the 4th centenary of the death of Tycho Brahe, perhaps the first great scientists in a modern sense.This famous Danish astronomer died in Prague on the 24th of October 1601, eleven days after he had attended a banquet at the Bohemian count of Rosenberg. Tycho was too...... courteous to obey the calls of nature during the hour-long dinner and finally his bladder burst, which led to his death. Or so the story goes. But is this the real cause of Tycho's death? Is it at all possible to die from a burst bladder? Or are there more likely explanations of his death?...

  14. Ein Blick hinter die Kulissen

    Directory of Open Access Journals (Sweden)

    Michaela Kempter

    2012-12-01

    Full Text Available In den Games-Workshops der wienXtra-spielebox lernen Kinder zwischen 7 und 12 Jahren empfehlenswerte Computer- und Konsolenspiele kennen und reflektieren nebenbei ihren Spielkonsum. Dieser Beitrag lässt die Leserinnen und Leser einen Blick hinter die Kulissen der Arbeit von wienXtra werfen.wienXtra-spielebox offers gaming workshops for young people between 7 and 12 years. The objective of these workshops is to explore new games that are evaluated as suited for the target group and to let the girls and boys reflect their playing habits. This article describes the work of wienXtra-spielebox.

  15. [Dying with cancer: Hollywood lessons].

    Science.gov (United States)

    Niemeyer, Fernanda; Kruse, Maria Henriqueta Luce

    2013-12-01

    The study attempts to understand how dying from cancer is portrayed by five movies produced in Hollywood between 1993 and 2006. Based on the cultural studies and their post-structuralism version and supported by the notions of discourse and subjectivity, as proposed by philosopher Michel Foucault, we suggest one of the possible readings of the movie picture corpus. We assess how the movie picture discourse acts as a cultural pedagogy that produces ways of seeing dying with cancer: immortalizing the healthy body image, silencing death, taking care of the dead body and, finally, accepting death. Our proposal is intended to stimulate reflections that may contribute to care and education in nursing.

  16. Disturbance of serotonin 5HT{sub 2} receptors in remitted patients suffering from hereditary depressive disorder

    Energy Technology Data Exchange (ETDEWEB)

    Larisch, R.; Vosberg, H.; Tosch, M.; Mueller-Gaertner, H.W. [Kliniken fuer Nuklearmedizin der Heinrich-Heine-Univ., Duesseldorf (Germany); Klimke, A.; Gaebel, W. [Kliniken fuer Psychiatrie der Heinrich-Heine-Univ., Duesseldorf (Germany); Mayoral, F.; Rivas, F. [Psychiatrische Klinik des Hospital Civil Carlos Haya, Malaga (Spain); Hamacher, K.; Coenen, H.H. [Inst. fuer Nuklearchemie des Forschungszentrums Juelich GmbH (Germany); Herzog, H.R. [Inst. fuer Medizin des Forschungszentrums Juelich GmbH (Germany)

    2001-08-01

    Aim: The characteristics of 5HT{sub 2} receptor binding were investigated in major depression in vivo using positron emission tomography and the radioligand F-18-altanserin. Methods: Twelve patients from families with high loading of depression living in a geographically restricted region were examined and compared with normal control subjects. At the time of the PET measurement all patients were remitted; in some of them remission was sustained by antidepressive medication. Binding potential was assessed by Logan's graphical analysis method. Results: The binding of F-18-altanserin was about 38% lower in patients than in healthy controls (p<0.001). A multiple regression analysis revealed that this difference was mainly induced by depression rather than by medication. Conclusions: The data suggest that 5HT{sub 2} receptors are altered in depression. We present evidence for a reduction of the receptor density, which might be usable as trait marker of subjects susceptible for depressive illness. (orig.) [German] Ziel: Die vorliegende Studie untersucht die 5HT{sub 2}-Rezeptorbindung bei depressiven Patienten in vivo mit der Positronen-Emissionstomographie und dem Radioliganden F-18-Altanserin. Methoden: Zwoelf Patienten aus Familien mit hoher Inzidenz fuer Depressionen, die in einer geographisch abgeschlossenen Region leben, wurden untersucht und mit gesunden Kontrollpersonen verglichen. Zum Zeitpunkt der PET-Messung waren alle Patienten klinisch remittiert, was bei einigen den Einsatz von Antidepressiva erforderlich machte. Das Bindungspotenzial wurde mit Logans graphischer Methode bestimmt. Ergebnisse: Die Altanserinbindung war bei den Patienten um ca. 38% niedriger als bei den Kontrollpersonen (p<0,001). Eine multiple Regressionsanalyse zeigte, dass dieser Unterschied in erster Linie durch die Erkrankung und nicht durch Praemedikation hervorgerufen wurde. Schlussfolgerung: Die Studie zeigt, dass die 5HT{sub 2}-Rezeptoren an der Depression beteiligt sind. Die

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

    Directory of Open Access Journals (Sweden)

    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.

  18. A Comparison of the Twelve Core Values of Thai People Defined by the Head of the National Council for Peace and Order (NCPO) Found in Thai Private and Public University Students

    Science.gov (United States)

    Ngammuk, Patariya

    2016-01-01

    This study aims to examine the twelve core values of Thai people found in Thai university students. The twelve values consist of the following attributes: 1.Upholding the nation, the religions and the Monarchy 2. Being honest, sacrificial and patient with positive attitude for the common good of the public 3. Being grateful to the parents,…

  19. Chirurgie in die Grieks-Romeinse era

    Directory of Open Access Journals (Sweden)

    François P. Retief

    2006-09-01

    Full Text Available In die Grieks-Romeinse era het mediese behandeling kenmerkend uit drie elemente bestaan, naamlik regimen (dieet en gesonde leefwyse, geneesmiddels en chirurgie – laasgenoemde alleen toegepas indien regimen en geneesmiddels onsuksesvol was. Bewyse van primitiewe chirurgie dateer terug na die Bronstydperk, en in Homerus se eposse is heelwat vermelding van die chirurgiese hantering van oorlogswonde, met tussenkoms van die gode. Met die koms van empiriese geneeskunde in die 5de eeu v.C. het chirurgie in die Hippokratiese Corpus prominent gefigureer met beduidende bydraes in veral die ortopediese veld en hoofbeserings. Uitbouing van anatomiese en fisiologiese kennis, gebaseer op disseksie van menslike kadawers in Alexandrië vanaf die laat 4de eeu v.C., het chirurgie ’n hupstoot gegee. Teen die Romeinse era vanaf die 2de eeu v.C. het snykundetegnieke (en -instrumente beduidend verbeter, maar is steeds oorwegend deur Griekse geneeshere beoefen. Van geneeshere is steeds verwag om al drie bovermelde terapeutiese modaliteite te bemeester, maar chirurgie het meer aansien verwerf en daar is al meer in onderafdelings van chirurgie soos oogheelkunde, vrouesiektes en verloskunde, blaaskwale en mond- en keelsnykunde gespesialiseer. Militêre geneeskunde was in die Romeinse Ryk ’n belangrike aktiwiteit, en het veral traumachirurgie uitgebou. Betreding van die buik- en toraksholtes was nie meer noodwendig fataal nie, en veeartsenykunde het tot stand gekom. Die eerste beduidende chirurgiehandboek ná die Hippokratiese Corpus is in die 1ste eeu n.C. deur Celsus opgestel. Vanaf die 3de eeu het die chirurgieberoep min vordering gemaak, die beroepstaal het mettertyd van Grieks na Latyn verander en kundigheid is later veral deur Islam-geneeshere na die Middeleeue en later oorgedra.

  20. The Cape Gunsmith / Die Kaapse Geweersmid

    Directory of Open Access Journals (Sweden)

    W. Otto

    2012-02-01

    Full Text Available In die Verslag van die Kommissie van Ondersoek na die Koordinering van Museums op 'n Nasionale Vlak (RP 113/1975, word vyf kolomme gewy aan historiese vuurwapens. Die kommissie wys op die belangrike plek wat vuurwapens in Suid-Afrika se wordingsgeskiedenis inneem en voeg daaraan toe dat geen museum in Suid-Afrika hierdie belangrike veld in sy uitstallings dek nie.

  1. Circumstances surrounding dying in the paediatric intensive care unit

    Directory of Open Access Journals (Sweden)

    Plötz Frans B

    2006-08-01

    Full Text Available Abstract Background Death is inevitable in the paediatric intensive care unit (PICU. We aimed to describe the circumstances surrounding dying in a PICU. Method The chart records of all patients less than 18 years of age who died at the PICU between January first 2000 and July first 2005 were retrospectively analyzed. Information regarding sex, age, length of stay, admission, diagnosis, and the way a patient died was registered. Post mortem information regarding natural versus unnatural death, autopsy and donation was obtained. Non-survivors were allocated in five groups: do-not-resuscitate (DNR, withholding and/or withdrawal of therapy (W/W, failed cardiopulmonary resuscitation (failed CPR, brain death (BD, and terminal organ failure (TOF. Results During the study period 87 (4.4% of the 1995 admitted patients died. Non-survivors were more often admitted during the day (54% and the week (68%. W/W was found in 27.6%, TOF in 26.4%, BD in 23.0%, failed CPR in 18.4%, and DNR in 4.6%. Forty-three percent died in the first two days, of which BD (40.5% and failed CPR (37.8% were most common. Seventy-five children (86% died due to a natural cause. Autopsy permission was obtained in 19 of 54 patients (35%. The autopsies confirmed the clinical diagnosis in 11 patients, revealed new information in 5 patients, and in 3 patients the autopsy did not provide additional information. Nine patients were medically suitable for organ donation and 24 patients for tissue donation, whereas consent was only obtained in 2 cases in both groups. Conclusion We observed that 43% of the patients died within the first two days of admission due to BD and failed CPR, whereas after 4 days most patients died after W/W. Autopsy remains an useful tool to confirm clinical diagnoses or to provide new information. Only a small percentage of the deceased children is suitable for organ donation.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. MOOCs; vanwaar al die ophef?

    NARCIS (Netherlands)

    Henderikx, Maartje; Kreijns, Karel

    2016-01-01

    MOOCs; vanwaar die ophef? Het nog maar zeer recente fenomeen MOOCs (massive open online courses) heeft zich in korte tijd al een onwrikbare positie weten in te nemen in het open online onderwijs. De hype rondom deze nieuwe manier van onderwijs geven bereikte zijn hoogtepunt in 2012, dat prompt werd

  5. Die Suche nach den Gottesteilchen

    CERN Multimedia

    2007-01-01

    2008 wird der größte jemals gebaute Teilchenbeschleuniger in Betrieb genommen Anlässlich des Mathematik-Jahres 2008 hat der Experimentalphysiker der Universität Hamburg und der designierte Generaldirektor des europäischen Zentrums für Teilchenphysik CERN in Genf, Rolf-Dieter Heuer, die Bedeutung des Dialogs zwischen Naturwissenschaftlern und Philosophen hervorgehoben.

  6. Robert Merton Dies at 92

    Science.gov (United States)

    Snell, Joel C.

    2006-01-01

    This article features Robert Merton, who died recently at age 92. Merton came into this world as a Jewish baby named Meyer Schkolnick. He lived in South Philly where his parents wrenched a living as blue-collar workers. Merton chose an Anglicized name to move into the Yankee dominated America of the 20's and 30's. At Harvard, he studied under…

  7. Oral papillary squamous cell carcinoma in twelve dogs.

    Science.gov (United States)

    Nemec, A; Murphy, B G; Jordan, R C; Kass, P H; Verstraete, F J M

    2014-01-01

    Papillary squamous cell carcinoma (PSCC) is a distinct histological subtype of oral squamous cell carcinoma (SCC), described in both dogs and man. In dogs, PSCC has long been considered a malignant oral tumour of very young animals, but it has recently been reported to occur in adult dogs as well. The aim of this study was to describe the major clinicopathological characteristics of canine oral PSCC (COPSCC). Twelve dogs diagnosed with COPSCC were included in this retrospective study (1990-2012). The majority (75%) of the dogs were >6 years of age (median age 9 years). All tumours were derived from the gingiva of dentate jaws, with 66.7% affecting the rostral aspects of the jaws. The gross appearance of the lesions varied, with one having an intraosseous component only. The majority (91.7%) of the tumours were advanced lesions (T2 and T3), but no local or distant metastases were noted. Microscopically, two patterns were seen: (1) invasion of bone forming a cup-shaped indentation in the bone or a deeply cavitating cyst within the bone (cavitating pattern), (2) histologically malignant growth, but lack of apparent bone invasion (non-cavitating pattern). The microscopical appearance corresponded to imaging findings in a majority of cases, with cavitating forms presenting with a cyst-like pattern of bone loss or an expansile mass on imaging and non-cavitating forms showing an infiltrative pattern of bone destruction on imaging. These features suggest two distinct biological behaviours of COPSCC.

  8. Sensitivity and growth of twelve Elatior begonia cultivars to ozone

    Energy Technology Data Exchange (ETDEWEB)

    Reinert, R.A.; Nelson, P.V.

    1979-12-01

    Twelve cultivars of Elatior begonia (Begonia X hiemalis Fotsch.) were exposed to O/sub 3/ at 25 and 50 pphM. The 'Schwabenland' group, 'Whisper 'O' Pink', and 'Improved Krefeld Orange' were the most sensitive, whereas 'Ballerina', 'Mikkell Limelight', and 'Turo' were the least sensitive. 'Rennaisance', 'Heirloom' 'Nixe', and 'Fantasy' were intermediate in sensitivity. The dry weight of foliage (stems plus leaves) of 9 cultivars exposed to O/sub 3/ was significantly less than that of control plants. Ozone at 25 and 50 pphM inhibited flower growth (including peduncles) and development in 4 and 8 of the 12 cultivars, respectively. Differences in flower weight ranged from 43 to 105% of the control at 25 pphM and from 25 to 98% of the control at 50 pphM, depending on cultivar. 1 table.

  9. Commercializing Government-sponsored Innovations: Twelve Successful Buildings Case Studies

    Science.gov (United States)

    Brown, M. A.; Berry, L. G.; Goel, R. K.

    1989-01-01

    This report examines the commercialization and use of R and D results funded by DOE's Office of Buildings and Community Systems (OBCS), an office that is dedicated to improving the energy efficiency of the nation's buildings. Three goals guided the research described in this report: to improve understanding of the factors that hinder or facilitate the transfer of OBCS R and D results, to determine which technology transfer strategies are most effective and under what circumstances each is appropriate, and to document the market penetration and energy savings achieved by successfully-commercialized innovations that have received OBCS support. Twelve successfully-commercialized innovations are discussed here. The methodology employed involved a review of the literature, interviews with innovation program managers and industry personnel, and data collection from secondary sources. Six generic technology transfer strategies are also described. Of these, contracting R and D to industrial partners is found to be the most commonly used strategy in our case studies. The market penetration achieved to date by the innovations studied ranges from less than 1% to 100%. For the three innovations with the highest predicted levels of energy savings (i.e., the flame retention head oil burner, low-E windows, and solid-state ballasts), combined cumulative savings by the year 2000 are likely to approach 2 quads. To date the energy savings for these three innovations have been about 0.2 quads. Our case studies illustrate the important role federal agencies can play in commercializing new technologies.

  10. The strong coupling regime of twelve flavors QCD

    CERN Document Server

    da Silva, Tiago Nunes

    2012-01-01

    We summarize the results recently reported in Ref.[1] [A. Deuzeman, M.P. Lombardo, T. Nunes da Silva and E. Pallante,"The bulk transition of QCD with twelve flavors and the role of improvement"] for the SU(3) gauge theory with Nf=12 fundamental flavors, and we add some numerical evidence and theoretical discussion. In particular, we study the nature of the bulk transition that separates a chirally broken phase at strong coupling from a chirally restored phase at weak coupling. When a non-improved action is used, a rapid crossover is observed at small bare quark masses. Our results confirm a first order nature for this transition, in agreement with previous results we obtained using an improved action. As shown in Ref.[1], when improvement of the action is used, the transition is preceded by a second rapid crossover at weaker coupling and an exotic phase emerges, where chiral symmetry is not yet broken. This can be explained [1] by the non hermiticity of the improved lattice Transfer matrix, arising from the c...

  11. Die spel van assosiasies in en om 'Die verlossing van die beeld' van Breyten Breytenbach

    Directory of Open Access Journals (Sweden)

    P.A. du Toit

    2005-07-01

    Full Text Available The play of association in and around 'The liberation of the image' by Breyten Breytenbach This analysis focuses on the conjunction of memory and imagination, which is an important impulse in, and key to, Breytenbach’s work. The play with language and with associations, the foregrounding, in the short story, “Die verlossing van die beeld” (Breytenbach, 1983 with its metafictional title and apparently divergent motifs (rain/water, watch, onion, the death and burial of a grandfather acts, as it were, as an invitation to the reader to become a co-player. The reader ventures on a search for traces, intertextual links within the Breytenbach oeuvre and for already acknowledged influences such as Surrealism (which in turn casts some light on the strange title of the story and the Eastern philosophies such as Zen and the even older Taoism. The analysis also takes into account the context in which “Mouroir” was written, namely Breytenbach’s term in prison (1975-1982. Seeing that the writer had to hand in his manuscripts to the jail authorities regularly, he might have decided, consciously or by intuition, to hide some thoughts and feelings behind a screen or a mask, in, for example in “Die verlossing van die beeld”, a lighter tone and irony.

  12. Die Wissensgesellschaft und die Bildung des Subjekts - ein Widerspruch?

    Directory of Open Access Journals (Sweden)

    Sebastian Hacke

    2009-05-01

    Full Text Available Der Beitrag untersucht, inwiefern sich medienpädagogisch relevante Diskrepanzen zwischen dem Diskurs der Wissensgesellschaft und jugendlichem Medienhandeln nachzeichnen lassen. Dazu werden zunächst einige Aspekte des Konstrukts Wissensgesellschaft skizziert, das in seiner gegenwärtig populären Form ins Fahrwasser an volkswirtschaftlichen Verwertungskalkülen orientierter Denkformen geraten ist. Dies wird in Bezug auf die sich daran gekoppelte Programmatik von Kompetenz diskutiert, welche den «homo oeconomicus» beschwört und sich darin konträr zu klassisch bildungstheoretischen Kategorien verhält. Weitergeführt werden diese Überlegungen anhand der Problematisierung des Medienkompetenztheorems, das sich bis heute damit schwer tut, sich von der Vereinnahmung durch zweckrationale und restringierende Tendenzen zu befreien. Argumentiert wird, dass mit Medienkompetenz zu wenig einer milieuspezifischen Differenzierung Rechnung getragen werden kann, die eine wichtige Prämisse für eine soziale Ungleichheiten ernst nehmende Medienpädagogik ist. Als eine Alternative diskutieren wir, inwieweit sich hier praxeologische Perspektiven zum Verständnis jugendlichen Handelns anbieten. Der Beitrag mündet in einige medienpädagogisch fruchtbare Ideen, in deren Zentrum eine reflexivere, stärker am Habitus von Jugendlichen orientierte Praxis steht.

  13. Die impak van tutoriale op die wiskundeprestasie van eerstejaarstudente

    Directory of Open Access Journals (Sweden)

    J. G. Maree

    2004-09-01

    Full Text Available

    Studente uit histories-agtergeblewe gemeenskappe in Suid-Afrika onderpresteer dikwels in wiskunde vanweë ’n verskeidenheid faktore. Aksienavorsing wat aan die (voormalige Technikon Noord-Gauteng uitgevoer is, om ondersoek in te stel na wyses waarop hierdie studente se wiskundeprestasie verbeter kan word, het die implementering van ’n tutoriaalstelsel behels. Kwantitatiewe en kwalitatiewe data is deur middel van ’n verskeidenheid instrumente ingesamel. Die resultate het sekere tendense in tersiêre wiskundeonderrig, wat in ’n tweede of derde taal geskied, uitgewys.

    Abstract

    The impact of tutorials on achievement in mathematics of first year students

    Historically disadvantaged students in South Africa often underachieve in mathematics due to a number of factors. Action research that was conducted at the (former Technikon Northern Gauteng to investigate ways in which these students’ achievements in mathematics could be improved comprised the implementation of tutorial sessions. Quantitative and qualitative data were gathered by means of a variety of instruments. The results revealed certain trends in tertiary mathematics education where learning takes place in a second or third language.

  14. Die aard en problematiek van vertaling

    Directory of Open Access Journals (Sweden)

    J. Swanepoel

    1980-05-01

    Full Text Available George Steiner (1975 se onlangse werk oor vertaling dra die treffende titel: After Babel. Dit is met hierdie dilemma wat die mens in sy na-babelse bestaan in sy strewe na sinvolle kommunikasie te kampe het: die bestaan van ’n magdom van tale wat geen individu, hoe begaafd ookal, eers kan droom om te beheers nie. Vandaar die strewe na die totstandbrenging van ’n eenvoudige en universele wereldtaal, Esperanto, of — meer algemeen — die behoefte aan vertaling. Maar vertaling is nie net ’n dilemma nie, dit is ook ’n uitdaging.

  15. Die Felsfassadengräber von Kyrene

    OpenAIRE

    Greve, Anika

    2006-01-01

    Die griechische Kolonie Kyrene wurde im letzten Drittel des 7. Jhs. v. Chr. einige Kilometer vom Mittelmeer entfernt im libyschen Innenland gegründet. Die Siedler waren dorische Griechen aus Thera im Süden der Kykladen. Nicht nur die erhaltenen innerstädtischen Gebäude zeugen von einem einstigen Wohlstand, auch die Nekropole nahm im Laufe der Zeit gewaltige Ausmaße mit aufwendig gestalteten Grabanlagen an, die sich rund um die urbane Bebauung entlang der Ausfallstraßen ausbreitete. Viele Ruhe...

  16. 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.

  17. Radiation therapy of regional lymph nodes in the treatment of seminomas compared with retroperitoneal lymphadenectomy. A retrospective analysis of 161 patients; Die Strahlentherapie der regionaeren Lymphknotenstationen bei der Behandlung des Seminoms im Vergleich zur retroperitonealen Lymphadenektomie. Eine retrospektive Auswertung von 161 Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Warszawski, N. [Klinik fuer Strahlentherapie, Magdeburg Univ. (Germany); Schmuecking, M. [Klinik fuer Strahlentherapie, Magdeburg Univ. (Germany); Samtleben, M. [Klinik und Poliklinik fuer Urologie, Magdeburg Univ. (Germany); Gademann, G. [Klinik fuer Strahlentherapie, Magdeburg Univ. (Germany); Allhoff, E.P. [Klinik und Poliklinik fuer Urologie, Magdeburg Univ. (Germany)

    1996-05-01

    Hundred and sixty-one patients with seminoma of stage I and II were retrospectively analysed. They were treated at the University of Magdeburg between 1975 and 1991 by radiation therapy of regional lymph nodes or by retroperitoneal lymphadenectomy. After high semicastration, 98 patients were irradiated, 63 patients received a retroperitoneal lymphadenectomy. Twenty-one patients were treated by adjuvant chemotherapy, too. The 5-year survival-rates according to Kaplan-Meier were 96% for stage I, 85% for stage IIA, 92% for stage IIB, and 68% for stage IIC. The overall survival rates for all stages were 95% after 2 years, 92% after 5 years, and 89% after 10 years. Relapses located retroperitoneally occurred significantly more often after retroperitoneal lymphadenectomy (9.5%) compared with radiation therapy (2.0%), relapses outside the operation situs or radiation fields, respectively, were registrated at the same frequency (4.8% and 7.1%, respectively). Disease-free survival rates decreased significantly with increasing stage (p<0.001, Wilcoxon-test). Relapses increased from 4.1% for stage I up to 58.3% for stage IIC. After semicastration for primary treatment of seminomas radiation therapy of the regional lymph nodes is the treatment of choice. Retroperitoneal lymphadenectomy is obsolete. (orig./MG) [Deutsch] 161 Patienten mit einem histologisch gesicherten Seminom der Stadien I und II wurden von 1975 bis 1991 an der Universitaet Magdeburg behandelt und retrospektiv analysiert. Nach erfolgter hoher Semikastration erhielten 98 Patienten eine Strahlentherapie, 63 Patienten wurden einer retroperitonealen Lymphadenektomie unterzogen. 21 Patienten erhielten zusaetzlich eine adjuvante Chemotherapie. Die Fuenf-Jahres-Ueberlebensraten (Kaplan-Meier-Methode) betrugen 96% im Stadium I, 85% im Stadium IIA, 92% im Stadium IIB, 68% im Stadium IIC. Die Gesamtueberlebensraten fuer alle Stadien lagen nach zwei Jahren bei 95%, nach fuenf Jahren bei 92%, nach zehn Jahren bei 89%. Alle

  18. Skrifberoep in die vorming van etiese uitsprake, Deel 1: ’n Etiese verstaan van die vrou in die Bybel

    Directory of Open Access Journals (Sweden)

    Adriaan L. Rheeder

    2012-11-01

    Full Text Available Na 30 jaar kon die grammaties-historiese metode van Skrifondersoek nie daarin slaag om die etiese probleem van die vrou in die kerklike ampte (en homoseksualiteit in die GKSA op te los nie. Hierdie metode kan na alle waarskynlikheid nie meer as die enigste verklaringsmetode gebruik word nie en moet deur ander uitgangspunte aangevul word. In hierdie artikel word twee hermeneutiese uitgangspunte bespreek wat saam met die grammaties-historiese metode in die vertolking van die Skrif gebruik kan word. Hierdie hermeneutiese uitgangspunte sal gedemonstreer word in ‘n bespreking oor die etiese verstaan van die vrou in die Bybel, spesifiek soos dit op die vrou in kerklike ampte toegepas word. In aansluiting by laasgenoemde twee vertrekpunte word in ’n opvolgartikel ’n verdere drie hermeneutiese vertrekpunte behandel. Die twee hermeneutiese vertrekpunte wat in hierdie artikel behandel word, staan as reëldoelwit en analogie bekend. Die eerste hermeneutiese vertrekpunt gaan uit van die veronderstelling dat die reëldoelwit van ’n teks swaarder weeg as die teks self, terwyl analogie van die veronderstelling uitgaan dat analogie as beredenering ’n aanvaarbare en noodsaaklike vertrekpunt is. Bogenoemde hermeneutiese vertrekpunte (vyf in totaal is op twee aannames gegrond. Ten eerste word aanvaar dat die Bybel, alhoewel ’n goddelike boek, ’n besliste kreatuurlike kant het wat in die vertolking daarvan in ag geneem moet word. Tweedens word geredeneer dat die Skrif nie ’n  teologiese boek is nie, wat beteken dat gelowiges in etiese sake waaroor daar twee verstaansmoontlikhede bestaan, die reg gegun moet word om self die Skrif te vertolk. Daar word tot die  gevolgtrekking gekom dat ’n etiese verstaan van die vrou daartoe moet lei dat die vrou as gelykwaardig aan die man beskou en behandel moet word, met die gevolg dat die vrou tot alle ampte in die kerk toegelaat moet word.Appeal to Scripture in the formation of ethical judgments, Part 1: An

  19. The Synthesis and Antitumor Activity of Twelve Galloyl Glucosides

    Directory of Open Access Journals (Sweden)

    Chang-Wei Li

    2015-01-01

    Full Text Available Twelve galloyl glucosides 1–12, showing diverse substitution patterns with two or three galloyl groups, were synthesized using commercially available, low-cost D-glucose and gallic acid as starting materials. Among them, three compounds, methyl 3,6-di-O-galloyl-α-D-glucopyranoside (9, ethyl 2,3-di-O-galloyl-α-D-glucopyranoside (11 and ethyl 2,3-di-O-galloyl-β-D-glucopyranoside (12, are new compounds and other six, 1,6-di-O-galloyl-β-D-glucopyranose (1, 1,4,6-tri-O-galloyl-β-D-glucopyranose (2, 1,2-di-O-galloyl-β-D-glucopyranose (3, 1,3-di-O-galloyl-β-D-glucopyranose (4, 1,2,3-tri-O-galloyl-α-D-glucopyranose (6 and methyl 3,4,6-tri-O-galloyl-α-D-glucopyranoside (10, were synthesized for the first time in the present study. In in vitro MTT assay, 1–12 inhibited human cancer K562, HL-60 and HeLa cells with inhibition rates ranging from 64.2% to 92.9% at 100 μg/mL, and their IC50 values were determined to be varied in 17.2–124.7 μM on the tested three human cancer cell lines. In addition, compounds 1–12 inhibited murine sarcoma S180 cells with inhibition rates ranging from 38.7% to 52.8% at 100 μg/mL in the in vitro MTT assay, and in vivo antitumor activity of 1 and 2 was also detected in murine sarcoma S180 tumor-bearing Kunming mice using taxol as positive control.

  20. Commercializing government-sponsored innovations: Twelve successful buildings case studies

    Energy Technology Data Exchange (ETDEWEB)

    Brown, M.A.; Berry, L.G.; Goel, R.K.

    1989-01-01

    This report examines the commercialization and use of R and D results funded by DOE's Office of Buildings and Community Systems (OBCS), an office that is dedicated to improving the energy efficiency of the nation's buildings. Three goals guided the research described in this report: to improve understanding of the factors that hinder or facilitate the transfer of OBCS R and D results, to determine which technology transfer strategies are most effective and under what circumstances each is appropriate, and to document the market penetration and energy savings achieved by successfully-commercialized innovations that have received OBCS support. Twelve successfully-commercialized innovations are discussed here. The methodology employed involved a review of the literature, interviews with innovation program managers and industry personnel, and data collection from secondary sources. Six generic technology transfer strategies are also described. Of these, contracting R and D to industrial partners is found to be the most commonly used strategy in our case studies. The market penetration achieved to date by the innovations studied ranges from less than 1% to 100%. For the three innovations with the highest predicted levels of energy savings (i.e., the flame retention head oil burner, low-E windows, and solid-state ballasts), combined cumulative savings by the year 2000 are likely to approach 2 quads. To date the energy savings for these three innovations have been about 0.2 quads. Our case studies illustrate the important role federal agencies can play in commercializing new technologies. 27 refs., 21 figs., 4 tabs.

  1. Ethnographische Filme und die Darstellung von Frauen

    Directory of Open Access Journals (Sweden)

    Judith Keilbach

    2002-03-01

    Full Text Available In dieser Filmographie werden ethnographische und koloniale Filme aus dem Bestand des Nederlands Filmmuseum kommentiert, die für die Frage nach der Darstellung von Frauen und Geschlechterverhältnissen von Interesse sind.

  2. [Die Gründung...] / Anders Henriksson

    Index Scriptorium Estoniae

    Henriksson, Anders

    2004-01-01

    Rets.: Karsten Brüggemann. Die Gründung der Republik Estland und das Ende des "Einen und unteilbaren Russland" : die Petrograder Front des Russischen Bürgerkrieges, 1918-1920. Wiesbaden : Harrassowitz, 2002

  3. Die ausbildung von wertbedeutungen im schuljugendalter*

    Directory of Open Access Journals (Sweden)

    Siegfried Heusinger

    1978-12-01

    Full Text Available Die folgenden Darlegungen stützen sich auf Untersuchungsergebnisse des Verlassers zur Sprachentwicklung in der Ontogenese. Angeregt wurde die UnterSuchung durch die besonders in den letzten Jahren in mehreren Ländern verstärkt erhobenen Forderungen, nicht nur die Sprache des Klein­ kindes, sondern vornehmlich den Entwicklungsstand der Schülersprache auf den einzelnen Klassenstufen zu erforschen und den Prozeß der Sprachentwicklung des Schülers genauer zu bestimmen. Die Forderungen sind (so z. B. in der DDR durch das Bestreben motiviert, weitere wissenschaftliche Voraussetzungen für die Verbesserung der muttersprachlichen Bildung und Erzliehung zu schaffen. Es geht also vor allem um Bedürfnisse des Muttersprachunterrichts, die aus der gesellschaftlichen Bedeutung der Sprache überhaupt und den steigenden Anforderungen an die gesellschaftliche Kommunikation insbesondere erwachsen.

  4. Die invloed van verpoeiering op die kwikinhoud van verskeie gesertifiseerde verwysingsmateriale

    Directory of Open Access Journals (Sweden)

    Frederick Roelofse

    2015-02-01

    Full Text Available Die meeste analitiese tegnieke wat gebruik word vir die bepaling van die kwikinhoud van aardmateriale benodig komminusie van monsters voor analise. Dit word gewoonlik bewerkstellig deur die vergruising van die monsters, gevolg deur die verpoeiering daarvan. Dit is bekend dat in konvensionele meule hitte tydens verpoeiering vrygestel word, en dit volg dat kwikverlies verwag kan word weens die element se vlugtigheid. Om kwikverlies tydens verpoeiering te bestudeer het ons nege gesertifiseerde verwysingsmateriale van stolrotse geanaliseer voor verpoeiering, asook na 3 en weer na 10 minute van verpoeiering, met behulp van ’n direkte kwikanaliseerder. Die resultate van die eksperimente dui daarop dat: (1 kwikverlies onbeduidend is na 3 minute van verpoeiering, (2 kwikverlies beduidend raak indien monsters oormatige verpoeiering ondergaan, (3 kwikverlies klaarblyklik nie deur mineralogie beheer word nie en (4 vir monsters met ’n lae kwikinhoud, kontaminasie tydens verpoeiering ’n baie meer beduidende invloed op die geanaliseerde kwikinhoud het as die duur van verpoeiering.

  5. Die tätigkeitstheoretische Perspektive

    OpenAIRE

    Stroh, Wolfgang Martin

    2012-01-01

    Die Perspektive, die der Autor entwickelt, ist die der dialektischen Tätigkeitstheorie. Gemäß dieser Theorie ist Musik eine spezifische Art der Aneignung von Wirklichkeit. SchülerInnen sollten im Musikunterricht lernen, bewusst, selbstbestimmt und sozial zu handeln, wenn sie sich durch Musizieren Wirklichkeit aneignen. Wenn SchülerInnen im Unterricht Musik machen, müssen sie sich daher auch des kulturellen Kontextes bewusst sein, dem die Musik entstammt. Sie sollten auch selbstbestimmt handel...

  6. Aanspreekvorme in die poësie

    Directory of Open Access Journals (Sweden)

    D. M. Wybenga

    1982-05-01

    Full Text Available By die deurblaai van die Groot Verseboek (hierna GV is dit opvallend dat daar so baie keer van aanspreekvorme in gedigte gebruik gemaak word. Van die heel eerste gedig wat daarin opgeneem is, naamlik Klaas Geswind en sy perd (p. 1 tot ’n gedig van die laaste opgenome digter, André le Roux, (struisbaai-blues, p. 506, gebruik digters telkens hierdie taalmiddel om een of ander spesifieke effek te verkry.

  7. “Ruik die verderf in die kieliebakke”: Breyten Breytenbach se blik op die lyk

    Directory of Open Access Journals (Sweden)

    M. Crous

    2008-07-01

    Full Text Available “Smell the rot in the armpits”: Breyten Breytenbach’s perspectives on the corpse The purpose of this article is to analyse Breyten Breytenbach’s so-called corpse poem, “bekommernis”, taken from his debut album “die ysterkoei moet sweet” (1964. The theoretical point of departure is the theories of Kristeva, in particular her essay on abjection. Not only does the article focus on Breytenbach’s portrayal of the abject, but also shows to what extent his use of language describing death, decay and the cadaver illustrates what Kristeva calls “a revolution in poetic language”. Given the fact that the poem is situated in a Zen Buddhist context, the Zen philosophy on death and dying is also taken into consideration when analysing aspects such as the dissolution of the ego, the bardos of death, et cetera.

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

    Directory of Open Access Journals (Sweden)

    Merisa Lodewyckx

    1981-08-01

    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.

  9. Twelve tips for creating trigger images for problem-based learning cases.

    Science.gov (United States)

    Azer, Samy A

    2007-03-01

    A trigger is the starting point of problem-based learning (PBL) cases. It is usually in the form of 5-6 text lines that provide the key information about the main character (usually the patient), including 3-4 of patient's presenting problems. In addition to the trigger text, most programs using PBL include a visual trigger. This might be in the form of a single image, a series of images, a video clip, a cartoon, or even one of the patient's investigation results (e.g. chest X-ray, pathology report, or urine sample analysis). The main educational objectives of the trigger image are as follows: (1) to introduce the patient to the students; (2) to enhance students' observation skills; (3) to provide them with new information to add to the cues obtained from the trigger text; and (4) to stimulate students to ask questions as they develop their enquiry plan. When planned and delivered effectively, trigger images should be engaging and stimulate group discussion. Understanding the educational objectives of using trigger images and choosing appropriate images are the keys for constructing successful PBL cases. These twelve tips highlight the key steps in the successful creation of trigger images.

  10. Die persoonlikheidseienskappe en bestuurspotensiaal van bestuursgemotiveerde persone

    Directory of Open Access Journals (Sweden)

    A. S. Engelbrecht

    1994-06-01

    Full Text Available The personality traits and managerial potential of managerial motivated persons: In the ligth of criticisms of the psychometric suitability of existing measures of managerial motivation a new scale, the Managerial Motivation Questionnaire (MMQ, was developed. This was done on the basis of a comprehensive study of the literature on managerial motivation and the role-motivation theory of Miner. The MMQ demonstrated adequate internal consistency. The aim of this study is to clarify the construct validity of the MMQ. Significant and positive correlations were found between managerial motivation, overall managerial potential, and nine managerial dimensions. The construct validity of the MMQ was further supported by correlations between sixteen personality traits and managerial motivation. Opsomming In die lig van kritiek teen die psigometriese geskiktheid van bestaande meetinstrumente van bestuursmotivering is 'n nuwe skaal, die Bestuursmotiveringsvraelys (BMV/ ontwikkel. Dit is gedoen op grond van die konseptuele omiyning van bestuursmotivering en die rolmotiveringsteorie van Miner. Die BMV vertoon toereikende interne konsekwentheid. Die doel van hierdie studie is om die konstrukgeldigheid van die BMV verder op te klaar. Beduidend positiewe korrelasies is tussen bestuursmotivering/ globale bestuurspotensiaal en nege bestuursdimensies gevind. Hierbenewens het die korrelasies tussen sestien persoonlikheidseienskappe en bestuursmotivering verdere ondersteunende bewyse gelewer van die konstrukgeldigheid van die BMV.

  11. Die Prozessionsspinner Mitteleuropas - Ein Überblick

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    Bräsicke, Nadine

    2013-01-01

    Full Text Available Die Auswirkungen des Klimawandels lassen sich bereits auch in Deutschland beobachten. Dabei werden die Waldökosysteme in besonderer Weise betroffen. Waldstandorte sind stärker trockenen Bedingungen ausgesetzt, die zusammen mit höheren Vegetationszeittemperaturen eine erhöhte Stressanfälligkeit der Bäume verursachen. Bei den Insekten beeinflusst eine erhöhte Temperatur u. a. die Entwicklungsdauer, die Populationsdichte und die Verwertbarkeit der Wirtspflanzen als Nahrung (BMLFUW 2003, Petercord et al. 2008. Es ist zu erwarten, dass die Wachstumsrate und die Entwicklung der Insektenarten beeinflusst wird (Netherer & Schopf 2009, die aufgrund eines relativ hohen Populationswachstums und hoher Mobilität durch Migration oder Adaption auf veränderte Klimabedingungen rascher reagieren (Harrington et al. 2001. Bei einigen Schädlingen zeichnet sich eine solche Entwicklung bereits ab. Unter ihnen befinden sich humanpathogene Arten, die zunehmend auch zum Forstschädling avancieren und die Waldbestände existenziell gefährden. Der Eichenprozessionsspinner gehört zu diesen Arten. Ebenfalls relevant für Mitteleuropa sind Thaumetopoea pinivora und Th. pityocampa, die mit dem Beitrag näher betrachtet werden.

  12. Die kuns van Maggie Laubser . 1

    Directory of Open Access Journals (Sweden)

    G. Dekker

    1953-03-01

    Full Text Available Dis vir my ’n groot genoeë om iets te mag sê oor die kuns van 'n vrouw at jare lank haar pad eensaam gegaan het, trou gebly het aan haar kunstenaarsoortuiging en nie toegegee het aan die smaak van die publiek, geenkompromieë daarmee gesluit het terwille van populariteit of stoflike gewin nie.

  13. Eenheid en differensiasie in die onderwys

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    B. C. Schutte

    1962-03-01

    Full Text Available Hierdie tenia van die interíakultêre lesings sny in werkliklieid oor alle fakulteite lieen en is ’11 probleem wal by elke dissipliiie ontstaan, sonder twyfel by almal wat met die mens en met levve te doen het, maar ook by die fisiese wetenskappe waar met die lewelosc skepping gewerk word. Waar ons in ons land en veral in Transvaal deesdae voortdurend te doen het met differensiasie in die onderwys, met A-, B- en C-bane, is hierdie beginsel van eenheid en verskeidenheid, van eeridersheid en ver- skillendbeid, van integrasie en differensiasie, van verdeelde beheer in die onderwys en van ’11 eenheidsheleid en -beheer, van nasionale en inter- nasionale onderwys, van verskillende skooltipes en van komprehensiewe skole e.d.m., voortdurend in die nuus. Saam met die eenheid en differen­ siasie in die volkewêreld van Afrika, is die probleem in die onderwys seker die popnlêrste; dis byna reeds gemeen|laas.

  14. Missionale kerkwees en die elektroniese sosiale media

    Directory of Open Access Journals (Sweden)

    Martin J. Lazenby

    2014-03-01

    Full Text Available Die geweldige toename in die benutting van die sosiale media as interaktiewe kommunikasiemiddel wêreldwyd, bied aan die Christelike kerk groot missionale geleenthede, maar stel ook groot uitdagings en eise. Hierdie geleentheid moet benut word om missionaal ’n verskil ten gunste van God se koninkryk te maak. Die inhoud en die kommunikasiestyl kom onder die vergrootglas. Hierdie artikel poog om ’n paar bybels-etiese beginsels aan te dui wat as basis vir die missionale styl van kommunikasie moet dien. As uitgangspunt word die Bybel as die Woord van God gebruik. Daar word geredeneer dat die moreel-etiese beginsels wat in die Bybel aan die gelowige voorgeskryf word, van die grootste belang is om gestalte te gee aan die koninkryk van God in hierdie wêreld wanneer via die sosiale media op horisontale vlak met mense gekommunikeer word. Dit gaan dus vir die gelowige nooit net om humanistiese, sosiale kommunikasie nie, maar altyd dat die beeld van God in hierdie wêreld geëer en sy koninkryk daardeur uitgebou word. Vir die Christen-gelowige gaan dit nooit om die mens nie, maar altyd om God se eer en die manifestasie van sy koninkryk.Being a missional church and the social media. The tremendous increase in using the social media as interactive communication medium worldwide creates the opportunity for the Christian church to make a missional difference in favour of God’s kingdom on earth. It also brings great challenges with it. This means that the way communication via the mass social media is done, becomes of the utmost importance. The content as well as the manner in which the communication is conducted must be considered. This article aims at providing certain basic biblical-ethical principles for communicating in the mass social media that will serve the missional calling of the church. The point of departure is the Word of God. The basic focus of the argument is that the moral-ethical principles given to the believer in the Bible are of the

  15. Straatsburg en artikel 2 van die dordtse kerkorde

    Directory of Open Access Journals (Sweden)

    L. F. Schulze

    1966-03-01

    Full Text Available In art. 2 K.O. word daar vier soorte kerklike dienste on dcrskei, nl. „dié van die bedienaars van die Woord, dié van die professore aan die teologiese skool, die van die ouderlinge, en dié van die diakens”.

  16. Thermal Fatigue of Die-Casting Dies: An Overview

    Directory of Open Access Journals (Sweden)

    Abdulhadi Hassan A.

    2016-01-01

    Full Text Available Coupled studies by experimental and numerical simulations are necessary for an increased understanding of the material behaviour as related to the interaction between the thermal and mechanical conditions. This paper focus on the mechanisms of thermal fatigue in the failure of dies and cores used in the die casting of aluminum alloys. The thermal fatigue resistance is expressed by two crack parameters which are the average maximum crack and the average cracked area. Samples of various types of H13 steel were compared with a standard H13 steel by testing under identical thermal fatigue cycles. To determine the thermal constraint developed in the sample during the test, a finite difference technique was used to obtain the temperature distribution, based on temperature measurements at the boundaries. The resulting stresses and strains were computed, and the strain calculated at the edge or weakest point of the sample was used to correlate the number of cycles to crack initiation. As the strain at the edge increased, the number of cycles to failure decreased. The influence of various factors on thermal fatigue behavior was studied including austenitizing temperature, surface condition, stress relieving, casting, vacuum melting, and resulfurization. The thermal fatigue resistance improved as the austenitizing temperature increased from 1750 to 2050ºF.

  17. Die effekvan punttoekenningstandaarde op die korrelasie tussen matriek- en universiteitsprestasie

    Directory of Open Access Journals (Sweden)

    G. K. Huysamen

    1999-06-01

    Full Text Available The effect of marking standards on the correlation between matriculation and university performance. Marking standards differ between courses in the sense that the same group of students shows different course means in different courses. Goldman andWidawski (1976 proposed a within-persons procedure to adjust for such differences between university departments and Elliott and Strenta (1988 adjusted this procedure to perform such corrections between courses within departments. In this study the correlation between matriculation performance and university performance has been increased by applying this adjustment not only to university courses but also to matriculation subjects. Opsomming Punttoekenningstandaarde verskil tussen kursusse in die opsig dat dieselfde groep studente verskillende kursusgemiddeldes in verskillende kursusse toon. Goldman en Widawski (1976 het 'n tussenproefpersoonprosedure voorgestel om vir sodanige verskille tussen universiteitsdepartemente te korrigeer en Elliott en Strenta (1988 het dit aangepas om sodanige korreksies tussen kursusse binne departemente uit te voer. In hierdie ondersoek is die korrelasie tussen matriekprestasie en universiteitsprestasie verhoog deur hierdie aanpassing nie slegs op universiteit-kursusse nie, maar ook op matriekvakke toe te pas.

  18. Clinical Criteria for Physician Aid in Dying.

    Science.gov (United States)

    Orentlicher, David; Pope, Thaddeus Mason; Rich, Ben A

    2016-03-01

    More than 20 years ago, even before voters in Oregon had enacted the first aid in dying (AID) statute in the United States, Timothy Quill and colleagues proposed clinical criteria AID. Their proposal was carefully considered and temperate, but there were little data on the practice of AID at the time. (With AID, a physician writes a prescription for life-ending medication for a terminally ill, mentally capacitated adult.) With the passage of time, a substantial body of data on AID has developed from the states of Oregon and Washington. For more than 17 years, physicians in Oregon have been authorized to provide a prescription for AID. Accordingly, we have updated the clinical criteria of Quill, et al., based on the many years of experience with AID. With more jurisdictions authorizing AID, it is critical that physicians can turn to reliable clinical criteria. As with any medical practice, AID must be provided in a safe and effective manner. Physicians need to know (1) how to respond to a patient's inquiry about AID, (2) how to assess patient decision making capacity, and (3) how to address a range of other issues that may arise. To ensure that physicians have the guidance they need, Compassion & Choices convened the Physician Aid-in-Dying Clinical Criteria Committee, in July 2012, to create clinical criteria for physicians who are willing to provide AID to patients who request it. The committee includes experts in medicine, law, bioethics, hospice, nursing, social work, and pharmacy. Using an iterative consensus process, the Committee drafted the criteria over a one-year period.

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

    Directory of Open Access Journals (Sweden)

    Jan A. Erasmus

    2014-03-01

    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

  20. Dying while living: a critique of allowing-to-die legislation.

    Science.gov (United States)

    Lappé, M

    1978-12-01

    Several US states are enacting 'right-to-die' laws, in the wake of the Karen Quinlan case. But the way such a law is drafted may cast doubt on a patient's existing common law right to control all aspects of his own treatment; it may give legal sanction to a lower standard of medical care that society at present expects from doctors; and it may lead to conflict between the patient's directive and his doctor's clinical judgement which cannot readily be resolved. The laws themselves are categorised as a) legalising active killing or b) defining rights of patients to control treatment or c) assigning to others the rights to control treatment where the patient is not competent. The California law is discussed critically. The conclusion is that such legislation is not a satisfactory answer to the ethical problem of euthanasia.

  1. Die Welt des Herrn Kuhn

    Science.gov (United States)

    Kern, Daniela

    Eines Morgens erwachte Herr Kuhn fröstelnd und staunte darüber, dass es in seinerWohnung eiskalt war. Dennoch quälte er sich aus seiner kuscheligen Bettdecke heraus und schlurfte ins Bad. "Hoffentlich wird wenigstens das Wasser warm", dachte er sich, als er den Wasserhahn betätigte - aber es kam nicht nur kein warmesWasser, außer einem unheilvollen Gluckser kam gar nichts aus der Leitung. "Dann werde ich wohl mal den Klempner anrufen", sprach er sich leise in den Bart und griff zu seinem Handy - doch das Netz war tot! Herr Kuhn begann nun, sich ernsthaft Sorgen zu machen, "Oje, was ist denn heute nur los? Ist irgendetwas Schlimmes passiert?" Um einen besseren Überblick über die Lage zu bekommen und sich austauschen zu können, brannte er nun förmlich darauf, rauszugehen und zur Arbeit zu fahren. An anderen Tagen, die er frisch geduscht und mit Kaffee und Marmeladen-Brot begann, war er selten so motiviert. So ging er also nun mit leerem Magen aus dem Haus. Hätte er den Versuch unternommen, sein tägliches Marmeladenbrot zuzubereiten, und dafür den Kühlschrank geöffnet, um das Marmeladenglas herauszunehmen, wäre ihm aufgefallen, dass auch die Stromversorgung Störungen unterworfen war, unschön zu erkennen an den ersten grünen, felligen Inseln auf seinem Lieblingskäse.

  2. Sonnet XXX: Love, dignity, and dying.

    Science.gov (United States)

    Ely, E Wesley

    2016-05-01

    All of us in medicine who care for patients who are chronically critically ill, dying of incurable illnesses, will be faced with discussions about the value of their lives and about the appropriateness of ongoing supportive care. Such discussions are good and true, and they must always be done within the context of the sanctity of every human life and the promise of God that we are His children, each and every one of us. In this article, I explore the end-of-life path of a patient with amyotrophic lateral sclerosis (ALS) and the courageous faith that she demonstrated in the face of her illness. I explore with you, the reader, the hard-core conversations that took place at her bedside and their meaning in light of Catholic moral teaching. This story is not meant to indicate that we should always do all interventions at all times for all patients. That would be a teaching counter to Evangelium vitae. This story is meant to help you think through the path of your patients and of you as a physician or other type of healthcare professional in serving your patients. Primum non nocere. Ad majorem Dei gloriam.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Die persoonlikheidsoriëntasieprofiel van die saluto-genies-funksionerende mens

    Directory of Open Access Journals (Sweden)

    A. M. Viviers

    1999-06-01

    Full Text Available The aim of this research is to integrate the theoretical personality profile of the salutogenic functioning person, drawn from the literature on Salutogenesis, with the personality orientation profile of the optimal functioning employee, as documented in the literature on Organisational and Personnel psychology. The integration is done according to intra- (cognitive affective, conative and physical characteristics and interpersonal characteristics. The two profiles could be integrated, according to these characteristics, into a profile of the salutogenic functioning person who handles life and work stressors effectively and functions optimally in his daily existence. This integration shows a theoretical relationship between the two constructs and confirms a meaningful relationship found in empirical research. Opsomming Die doel van hierdie navorsing is om die teoretiese persoonlikheidsprofiel van die salutogenies-funksionerende mens vanuit die literatuur oor Salutogenese met die persoonlikheidsorientasieprofiel van die optimaal- funksionerende werknemer soos deur die Organisasie- en Personeelsielkunde-literatuur voorgehou, te integreer. Die integrasie word volgens intra- (kognitiewe, affektiewe, konatiewe en fisiese eienskappe en interpersoonlike eienskappe gedoen. Daar is bevind dat die twee profiele volgens die eienskappe geïntegreer kan word tot 'n profiel van die salutogenies-funksionerende mens wat die stressors van die lewe en werk effektief kan hanteer en sodoende optimaal in sy daaglikse bestaan funksioneer. Die integrasie bevind 'n teoretiese verband tussen die twee konstrukte. Dit bevestig empiriese navorsing wat 'n beduidende verband tussen die twee konstrukte bevind het.

  5. Was die neuen Frauen wollen

    OpenAIRE

    Wilhelm, Hannah; Meyen, Michael

    2004-01-01

    Seit Mitte der 90er Jahre hat sich eine neue Generation von Frauenzeitschriften auf einem als übersättigt geltenden Markt etabliert. Diese Blätter richten sich an Frauen zwischen 20 und 35 Jahren. Glamour aus dem Condé Nast Verlag scheint die Perfektion dieses neuen Zeitschriftentypus zu sein. Das Magazin im Pocket-Format wurde sofort nach seiner Einführung im Februar 2001 Marktführer im Segment der monatlich erscheinenden Frauenzeitschriften. Der Beitrag geht der Frage nach, wie dieser Erfol...

  6. An Integrated Die Casting Design System

    Institute of Scientific and Technical Information of China (English)

    Y; K; Woon; K; S; Lee

    2002-01-01

    Die casting process is one of the prime options for m anufacturing precisely dimensioned, sharply defined metal parts. The design of d ie casting dies comprises several stages and entails a large amount of time. Tra ditionally, the different stages of the die design were not integrated but exist as separate entities. Moreover, recurring modifications or even redesigns are r equired due to the complexity in achieving an accurate initial die design. As a result, die design is usually time-consuming and cos...

  7. USING LOGIC COMPONENTS FOR CONCEPTUAL DIE DESIGN

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Logic components are used to support the conceptual design. Taking the stamping die structure as the research object,several logic components are defined for the conceptual die construction design. A new method-logic assembly modeling is presented to satisfy the characteristic of the top-down die design process. Representing shapes and spatial relations in logic can provide a natural,intuitive method of developing complete computer systems for reasoning about die construction design at the conceptual stage. This method can reflect the designer's thought clearly and provide the designer with a test bed for generating alternatives and performing reasoning work at the conceptual die design stage.

  8. Genl. Koos De La Rey, die krygsman.

    Directory of Open Access Journals (Sweden)

    J. S. du Plessis

    1959-03-01

    Full Text Available 22 Oktober is die geboortedag van genl. Koos de la Rey, wat van dag tot ons heldeverlede behoort. Vanjaargedenk ons ook op 11 Oktober die uitbreek van die Tweede Vryheidsoorlog, sestig jaar gelede. Daarom wil ek graag by hierdie geleentheid die persoon van Koos de la Rey in herinnering roepen by wyse van hierdie artikel huldebring aan hom wat God aan ons volkgegee het op ’n tydstip toe sulke mannedringend noodsaaklik was; ’n man wat in die ure van dood en benoudheid leidingkon gee; ’n man sonder wie onsvolksgeskiedenis beslis armer sou gewees het. Aangesien hy by uitstek krygsmanen veldheer.

  9. Anforderungen an die Detektoren von DIVA.

    Science.gov (United States)

    Wagner, S. J.

    Neben dem optischen System sind die Detektoren in der Fokalebene die wichtigste Komponente des Instruments eines astrometrischen Minisatelliten. Einer möglichst optimalen Auswahl des Detektorsystems und seiner Operationsmodi kommt daher eine entscheidende Bedeutung zu. In diesem Beitrag werden die Anforderungen vorgestellt, die sich zum gegenwärtigen Stand der Planung eines Interferometrie-Minisatelliten für astrometrische und photometrische Untersuchungen ergeben. Sie basieren auf dem grundlegenden Missionskonzept für die DIVA Mission (Bastian et al., 1996) und dem an der Landessternwarte Heidelberg zusammen mit dem ARI Heidelberg und DSS Ottobrunn erarbeiteten optischen Konzept des Instruments.

  10. Die resepsie van die Heidelbergse Kategismus (Sondag 17 en 22 insake die opstanding in die negentiende-eeuse Nederduitse Gereformeerde Kerk (Deel 1

    Directory of Open Access Journals (Sweden)

    Johannes W. Hofmeyr

    2013-06-01

    Full Text Available Met die 450e herdenking van die Heidelbergse Kategismus (HK as vertrekpunt word in twee artikels gepoog om lig te werp op die plek, die rol en die interpretasie van die opstanding van Jesus Christus uit veral Sondag 17 en 22, spesifiek in die konteks van twee besondere eras in die Nederduitse Gereformeerde (NG Kerk. Na ’n kort bespreking van die Heidelbergse Kategismus , word in hierdie eerste artikel uitgebreid gekyk na die resepsie van die betrokke HK-geloofsartikels in die era van Andrew Murray, spesifiek teen die agtergrond van die negentiende-eeuse liberale teologie in Nederland. In ’n tweede artikel word soortgelyk gekyk na die resepsie van die betrokke HK-geloofsartikels in die NG Kerk na 2000, veral teen die agtergrond van die herverskyning van die liberale teologie in die vorm van die Jesus Seminaar, die Nuwe Hervorming en die aanhangers daarvan se standpunte binne die NG Kerk. Sowel die negentiende-eeuse liberale stryd in die NG Kerk as die stryd rondom die opstanding in die NG Kerk van die eerste dekade van die een-en-twintigste eeu, soos in die tweede artikel duidelik sal blyk, was gekenmerk deur kontekstueelbepaalde uniekhede. Die gemene deler is dat albei deel was van tye van teologiese vrysinnigheid. In die lig van hierdie bespreking, ook ten opsigte van die negentiende eeu, sal tot die gevolgtrekking gekom word dat die NG Kerk, wat sy identiteit as gereformeerde kerk betref, tans waarskynlik in ’n kritieke geloofs- en toekomskrisis verkeer wat kommerwekkende gevolge vir sy Skrifverstaan en getuienis as belydenis en belydende kerk van Jesus Christus en sy toekoms inhou. Alleen ’n duidelike visie, verantwoordelike leierskap en die herontdekking van die kruis en die opstanding as ononderhandelbare heilsgebeure, wat ook deur die HK gehandhaaf word, sal die NG Kerk kan red van ’n snelwentelende afwaartse spiraal. Slegs die pasgenoemde faktore kan ’n herstellende, positiewe en dinamiese oplossing vir hierdie proses bied wat

  11. Percutaneous endoscopic colostomy (PEC): an effective alternative in high risk patients with recurrent sigmoid volvulus.

    Science.gov (United States)

    Khan, Muhammad Aamir Saeed; Ullah, Sana; Beckly, David; Oppong, Fielding Christian

    2013-11-01

    Treatment of recurrent sigmoid volvulus is a major challenge in frail and elderly patients with multiple co-morbidities. Early management involves endoscopic decompression with high success rate, however, its recurrence make it a real challenge as most of these patients are not suitable for major colonic resection. The aim of this study was to assess the role of percutaneous endoscopic colostomy (PEC) in the treatment of recurrent sigmoid volvulus in these patients. Twelve PEC procedures were performed in 8 patients under our care. This prevented major colonic resection in 7 patients. One patient underwent sigmoid resection and died with postoperative complications. Two patients experienced minor complications. Three patients required repeat procedures for permanent PEC tube placement. Six patients managed permanently with PEC procedure. PEC is an effective treatment for recurrent sigmoid volvulus in high-risk elderly patients.

  12. Subarachnoid hemorrhage without aneurysm; Die Subarachnoidalblutung ohne Aneurysmanachweis

    Energy Technology Data Exchange (ETDEWEB)

    Mueller-Forell, W. [Institut fuer Neuroradiologie des Universitaetsklinikums Mainz (Germany); Welschehold, S. [Klinik und Poliklinik fuer Neurochirurgie des Universitaetsklinikums Mainz (Germany); Koehler, J. [Klinik und Poliklinik fuer Neurologie des Universitaetsklinikums Mainz (Germany); Schicketanz, K.H. [Institut fuer Medizinische Biometrie, Epidemiologie und Informatik des Universitaetsklinikums Mainz (Germany)

    2002-11-01

    The rupture and bleeding of intracranial aneurysms is the most common cause of a spontaneous, non-traumatic subarachnoid hemorrhage (SAH). In up to 20% of these patients, no aneurysm is found, but the prognosis of these patients is known to be better than in those with aneurysms. The retrospective evaluation of the initial CT- and angiographic findings of 773 patients with spontaneous SAH, who underwent (up to three) 4-vessel DSA, brought a percentage of 12.4% with negative angiography. We found the favourable prognosis of these patients with negative angiography not only to be dependant from the distribution of the hemorrhage, with preference to perimesencephalic pattern, but the initial clinical state. 85% of our patients, who presented with perimesencephalic blood pattern and even 80% of those patients with additional intraventricular hemorrhage but the good clinical condition of Hunt-Hess I/II were discharged without neurological deficits. We recommend the obligatory 4-vessel catheter-angiography (DSA) in all patients with spontaneous SAH, independent of the blood pattern on initial CT, and one control in the presence of other than perimesencephalic subarachnoid hemorrhage, CTA might be reserved for additional controls. (orig.) [German] Die Aneurysmablutung stellt die haeufigste Ursache einer spontanen, nichttraumatischen Subarachnoidalblutung (SAB) dar, bei einem Teil dieser Patienten kann jedoch kein Aneurysma nachgewiesen werden. Die Prognose dieser Patienten ist, im Vergleich zu denen mit positivem Aneurysmabefund, deutlich guenstiger. Die retrospektive Evaluation der initialen CT- und Angiographiebefunde sowie des klinischen Verlaufs von 773 Patienten, die innerhalb der letzten 11 Jahre nach einer spontanen SAB einer 4-Gefaessangiographie (DSA) unterzogen worden waren, ergab in unserem Krankengut einen Prozentsatz von 12,4% mit endgueltig fehlendem Aneurysmanachweis, wobei bis zu 3 Kontrollangiographien durchgefuehrt worden waren. Der positive Verlauf des

  13. Ouditiewe aandag by die voorskoolse kind

    Directory of Open Access Journals (Sweden)

    Elmarie Niemand

    1980-08-01

    Full Text Available Daar is met hierdie navorsingsprojek gepoog om 'n duidelike beeld te vorm van ouditiewe aandagsprosessering by die voorskoolse kind. Aangesien ouditiewe aandagsprosessering van groot belang is vir die kind wat skool toe gaan is daar op die groep wat in die daaropvolgende jaar skool toe gaan besluit. 'n Groep van 64 kinders is geselekteer. Daar is gebruik gemaak van 'n gegradeerde ouditiefgerigte  ondersoekprogram wat so saamgestel is dat dit wetenskaplik verantwoordbaar is. In sy geheel gesien dui die navorsingsresultate daarop dat die basiese ontwikkelingsproses van ouditiewe aandagsprosessering op hierdie ouderdom (5;2 tot 5;8 voltooi is. 'n Verdere evaluering van die resultate in terme van die uiteengesette doelstellings van die navorsingsprojek dui daarop dat kinders in hierdie ouderdomsgroep nog soms moeite ondervind om aan 'n ouditiewe sei binne omgewingslawaai aandag te skenk. Bekende seine verhoog die vermoë om aandag te skenk. Daar kon egter nie vir alle aannames wat in die literatuur gemaak word, bewys gevind word nie.

  14. Modeling of high temperature- and diffusion-controlled die soldering in aluminum high pressure die casting

    DEFF Research Database (Denmark)

    Domkin, Konstantin; Hattel, Jesper Henri; Thorborg, Jesper

    2009-01-01

    Soldering of cast alloys to the dies has been a continuing source of die surface damage in the aluminum die-casting industry. To reduce the repair and maintenance costs, an approach to modeling the damage and predicting the die lifetime is required. The aim of the present study is the estimation...... of the die lifetime based on a quantitative analysis of die soldering in the framework of the numerical simulations of the die-casting process. Full 3D simulations of the process, including the filling. solidification, and the die cooling, are carried out using the casting simulation software MAGMAsoft....... The resulting transient temperature fields on the die surface and in the casting are then post-processed to estimate the die soldering. The present work deals only with the metallurgical/chemical kind of soldering which occurs at high temperatures and involves formation and growth of intermetallic layers...

  15. Simulating a high pressure die casting

    Energy Technology Data Exchange (ETDEWEB)

    Goldak, J.; Zhou, J.; Downey, D.; Aldea, V.; Li, G.; Mocanita, M. [Carleton Univ., Ottawa, Ontario (Canada)

    2000-07-01

    High pressure die casting is simulated for parts with complex geometry such as a large automotive transmission case. The closed die is filled in approximately 40 ms, the casting cools in the closed die for approximately 40s, to open the die, eject the casting and spray the die cavity surface requires another 40s. This 3D cyclic process is simulated using the following coupled composite solvers: the energy equation in the die and in the casting with solidification; filling of the casting by a droplet or a Navier-Stokes solver, and thermal stress analysis of the casting machine, casting and die during the cycle. This thermal analysis can be done for both starting and stopping transients and for the cyclic steady state. The software enables this analysis to be done almost automatically by designers. (author)

  16. The Decisonal Autonomy Defending the Right to Die With Dignity

    Directory of Open Access Journals (Sweden)

    Riva Sobrado de Freitas

    2016-12-01

    Full Text Available This article aims to verify the possibility that the terminal patient, provided with decisional autonomy, can claim the right to die with dignity. To achieve the intent, it was done a bibliographic exploratory-explanatory research, qualitative, using the deductive method. Concluding that, even if the subject is polemic, the decisional autonomy deserves to be considered, including in the execution of the right to die with dignity, since it is intended to safeguard the human being in the most intimate aspects of one’s life and, because, choose the death with dignity doesn’t mean to give up from the right to life.

  17. An Experiment in Humanistic Management within Community College District Twelve, Centralia/Olympia, Washington.

    Science.gov (United States)

    Miller, Dale A.; Hurley, John A.

    Community College District Twelve, a multi-college district serving a two-county area in southwestern Washington, has attempted to incorporate at administrative levels many of the humanistic, process-oriented principles of management discussed by Maslow and Maccoby. A concept of the ideal leadership style for District Twelve guides the selection…

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Bacteriological and clinical evaluation of twelve cases of post ...

    African Journals Online (AJOL)

    2008-06-01

    Jun 1, 2008 ... from a case of osteosarcoma with necrotic tissues. the anaerobic bacteria were 100% sensitive to metronidazole ... metastases even after repeated surgical intervention ..... a patient to pulmonary aspergillosis (6) while.

  1. Implikasies van ontwikkelings in die leerstelling van goddelike genesing binne die Pinksterbeweging

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    Marius Nel

    2014-03-01

    Full Text Available Die Pinksterbeweging het met verloop van tyd sy begrip van die leer van goddelike genesing verander. Die veranderings is hoofsaaklik as gevolg van vorderings wat deur die mediese wetenskap gemaak is en die pinksterteologie moes opnuut die verhouding tussen versoening en heling definieer. Die veranderings word in terme van die geskiedenis van die wit afdeling van die Apostoliese Geloof Sending van Suid-Afrika (AGS, die grootste pinksterdenominasie in Suid-Afrika, beskryf. Dit dien tot ’n groot mate as verteenwoordigend van veranderings in die res van die AGS, maar ook van die Pinksterbeweging as sodanig. Die ontleding toon dat die veranderde houding teenoor die gebruik van medisyne en inenting sowel as mediese prosedures soos operasies pinksterkerke uiteindelik dwing om toegewings in sy genesingsbediening te maak wat aan sy Skrifbeskouing verwant is. Dat die kerk veranderings aanbring in ’n belangrike leerstelling soos dié van goddelike genesing, hou belangrike implikasies vir die kerk in. Die implikasies hou verband met die wyse waarop die pinkstermense die Bybel lees en benut en dit noodsaak die Pinksterbeweging om ook oor ander leerstellings na te dink wat uitdagings daaraan stel, byvoorbeeld die eskatologie en ekklesiologie.Implications of developments in die doctrine of divine healing in die Pentecostal movement. The Pentecostal movement changed over time its understanding of the doctrine of divine healing. These changes are mainly in the attitude towards the advances made by medical science and reflected in the way pentecostal theology defined the relation between atonement and healing. The changes are described in terms of the history of the white division of the Apostolic Faith Mission of South Africa (AFM, the largest pentecostal denomination within South Africa. It serves to a large extent as representative of the changes in the AFM, but also the Pentecostal movement per se. The analysis shows that the changed attitude towards the

  2. Deathly silence and apocalyptic noise: Observations on the soundscape of the Book of the Twelve

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    Aaron Schart

    2010-03-01

    Full Text Available This paper proposes a reading of the Book of the Twelve (used interchangeably with �Twelve� and �Book� for convenience that concentrates on the sound that is included in the description of the world of the text. Three onomatopoeic devices are singled out. First, the mourning cry h�y is considered. This interjection is used differently in several of the writings: in Amos (5:18; 6:1 the prophet cries out in compassion with the addressees. By contrast, in Nahum 3:1 and Habakkuk 2:6�19, h�y is uttered in a mood of mockery. In Zechariah 2:10 a third, joyful h�y is used. It appears that the different usages cohere nicely with the overall structure of the Book of the Twelve. Secondly, the interjection has likewise shows different usages. In Amos 6:10 and 8:3, it simulates the last breath of Israelites dying when the land is devastated. By contrast, in Habakkuk 2:20, Zephaniah 1:7 and Zechariah 2:17, the addressees are directed to be silent before YHWH. This command should be perceived as an act of reverence. Again, the sequence of the occurrences coheres with the overall structure of the Book of the Twelve. Of special relevance is that the last three instances build a frame around the Babylonian exile, which lies between Zephaniah and Haggai. The third example is the phrase ham�n�m, ham�n�m in Joel 4:14. The author employs an irregular double plural to construe this place as the loudest spot (�apocalyptic noise� within the Twelve.Setu sa go tiba le modumo wa aphokhaliptiki: Ditemogo ka medumo ya Puku ya ba LesomepediPampiri ye e �i�inya go balwa ga Puku ya ba Lesomepedi (yeo e ka nogo bit�wa �Lesomepedi� goba �Puku� go bebofat�a ditaba ka go gatelela modumo wo o lego ka gare ga tlhaloso ya lefase la go tswala dingwalo t�e. Ditsela t�e tharo t�a onomathopoiki di bewa pepeneng. La mathomo, go �et�wa sello sa mahloko sa h?y. Lelahlelwa le le �omi�wa ka go fapana mo dingwalong t�e mmalwa: go Amosi

  3. Dat die klip kan heers: Pieter Fourie se Die koggelaar

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    J. L. Coetser

    1991-05-01

    Full Text Available Die koggelaar (The teaser, by playwright Pieter Fourie, is generally regarded as exceptional among his recent works. The purpose of this article is to discuss the title and drought as recurring themes in the drama. The teaser is Boet Cronje, but he is of the opinion that everyone teases him. In an ironic twist of events he finally believes that God teases him by not providing the rain he so desperately needs. An investigation of the text reveals the utilization of psychoanalytical theory, i.e. the theory of the collective and the personal unconscious as formulated by Jung. In this case physical drought initiates events which lead to the development of a fully-fledged psychosis in Boet. As a consequence of the interconnection of the personal and the collective unconscious the physical drought surrounding Boet additionally becomes a dramatic metaphor for the figurative drought in the community of which he is part.

  4. Verspreiding en habitats van Unio caffer Krauss, 1848 (Bivalvia: Unionoida: Unionidae in Suid-Afrika gebaseer op die rekords in die databasis van die Nasionale Varswaterslakversameling

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    K. N. de Kock

    2010-01-01

    Full Text Available Die kosmopolities-verspreide Unionoida bereik hul grootste diversiteit in Noord-Amerika. In Suid-Afrika word twee genera van die familie Unionidae, naamlik Unio en Coelatura wat vier spesies insluit, aangetref. Hierdie artikel handel oor die verspreiding en habitats van Unio caffer Krauss, 1848 gebaseer op die rekords in die Nasionale Varswaterslakversameling (NVWSV van Suid-Afrika. Alhoewel dit elders in Suid-Afrika sporadies aangetref is, is die Wes-Kaap die enigste provinsie waarvan geen monster op rekord in die databasis van die NVWSV is nie. Van die 58 monsters wat op rekord is, is die meerderheid in riviere (32.8% en damme (20.7% versamel en in watertoestande wat as standhoudend, staande, helder en vars beskryf is. ’n Temperatuur-indeks wat vir hierdie spesie bereken is, het dit vyfde in rangorde geplaas van die 12 Bivalvia-spesies wat in die databasis verteenwoordig word op grond van ’n assosiasie met lae omgewingstemperature. ’n Besluitnemingsboom-analise het aangedui dat temperatuur, substratum en waterbronne die mees betekenisvolle bydrae gelewer het tot die daarstelling van die gedokumenteerde geografiese verspreiding van U. caffer. Omdat omvattende opnames van varswater Mollusca deur staatsinstansies reeds in die tagtigerjare van die vorige eeu uitgefaseer is en die meerderheid versamelpunte sedertdien nie weer gemonster is nie, is kennis oor hul huidige stand van bewaring en spesiediversiteit gebrekkig. Negatiewe resultate by drie voormalige lokaliteite van U. caffer wat wel intussen deur die outeurs besoek is, dui egter daarop dat die voortbestaan daarvan, soos van sommige verwante spesies elders in die wêreld, bedreig word. Dit word bepleit dat opnames van varswater Mollusca met die gedokumenteerde verspreiding in die databasis van die NVWSV as riglyn, beplan en uitgevoer behoort te word. Die resultate van sulke opnames behoort ’n groot bydrae te lewer om die huidige stand van die verspreiding en spesiediversiteit van

  5. Sling for correcting uterine prolapse: twelve years experience.

    Science.gov (United States)

    Khanam, R A; Rubaiyat, A; Azam, M S

    2014-01-01

    Pelvic organ prolapse is a common morbidity among Bangladeshi women. Both patient and surgeon prefer vaginal hysterectomy for the treatment of this condition and occasionally they choose Fothergill's operation. Uterine suspension is suitable for the young women to preserve the uterus. This observational study was carried out in three teaching hospitals and two other non government hospitals for the period of 12 years among 280 patients with 1st, 2nd and 3rd degree uterine prolapse. Follow up done at 6th week , 6th month, 1st year, 5th year, 10th year and 12th year for recurrence of prolapse, dragging pain and dyspareunia. Among 280 patients >60% patients were of 26-30 years age group. In last follow up at 12th year 2(0.71%) women complained feeling of some descend of uterus, 1(0.36%) complained dragging pain in abdomen and I (0.36%) complained dyspareunia. All patients expressed satisfaction which indicates psychological well being. Uterine sling is an effective procedure to save uterus in young women to improve their quality of life.

  6. Quality of dying and death with cancer in Israel.

    Science.gov (United States)

    Braun, Michal; Hasson-Ohayon, Ilanit; Hales, Sarah; Zimmermann, Camilla; Rydall, Anne; Peretz, Tamar; Rodin, Gary

    2014-07-01

    The quality of dying and death refers to the evaluation of the final days of life and the moment of death with respect to how it is prepared for, faced and experienced by those with a terminal illness. It includes experience in multiple domains: physical, psychological, social, spiritual or existential, the nature of health care, life closure and death preparation, and the circumstances of death. To explore the quality of dying and death in cancer patients in Israel and its relationship to place of death and socio-demographic characteristics of the primary caregivers and the deceased. Retrospective assessment of the quality of dying and death, based on caregiver responses to the Quality of Dying and Death (QODD) questionnaire (overall score ranges from 0 to 100; higher scores reflect better dying and death experiences) 8 to 10 months after the death. Ninety-five caregivers of Jewish cancer patients, most of whom were female spouses or children of the deceased. Mean QODD score was 57.2 (standard deviation [SD]=15), which is in the low-moderate range. Place of death, gender and age of the caregiver, and age of the deceased, were associated with QODD score. This retrospective study in Israel demonstrated that the overall quality of dying and death was regarded as poor by almost half of the caregivers. These findings may reflect the relative lack of specialized palliative care and advance care planning in Israel at the time of this study, which took place between 2006 and 2009. Further research and enhancement of palliative care resources may be needed in Israel and several encouraging recent developments (e.g. staff training and legislation) suggest that such changes are now underway.

  7. Stereotactic radiosurgery with the gamma knife for brain metastases in patients with lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Morikawa, Tetsuyuki; Takeuchi, Kouichiro; Fujino, Hideyo; Fukumura, Motoyuki; Kimura, Midori; Furuie, Hitoshi; Nagano, Naotomi; Kakuta, Yukio; Tashiro, Yukio [Yokohama Rosai Hospital (Japan)

    1995-01-01

    Between February 1992 and April 1993, six patients with lung cancer were treated with gamma knife radiosurgery for brain metastases. Five patients had adenocarcinoma, and one patient had small cell carcinoma. Two patients had solitary metastases, and four patients had multiple metastases. Twelve metastases were treated with the gamma knife (peripheral dose between 12 Gy and 25 Gy). After radiosurgery, three complete and eight partial responses were achieved, which resulted in an overall response rate of 92%. In two patients, histological studies showed that few viable cells were surrounded by necrosis. Neurological status improved in all patients, and none died of complications. However, four of six patients later developed new intracranial metastases outside the treatment field. These data suggest that radiosurgery with the gamma knife is effective against brain metastases in patients with lung cancer, especially when the lesions are deep in the brain. (author).

  8. Bedryf- en organisasiesielkunde - Die grondslag van personeelbestuur

    Directory of Open Access Journals (Sweden)

    L. D. Coetzee

    1978-11-01

    Full Text Available In a recent article in People and Profits Whyte (1978 attempts to distinguish between Industrial Psychology and Personnel Management and states that Industrial Psychology is "one specific aspect" of Personnel Management. Whether such difference exists is analysed in terms of Whyte's definition and views of Personnel Management and Industrial Psychology and recent developments in the field of Industrial and Organizational Psychology. It is concluded that differences do exist but that they are not the same as those which Whyte emphasizes. In order to promote common objectives both the similarities and differences should be recognized and close co-operation between Industrial and Organizational psychologists and Personnel Mangers should be encouraged.OpsommingIn 'n onlangse artikel in People and Profits poog Whyte (1978 om 'n onderskeid te tref tussen Bedryfsielkunde en Personeelbestuur en spreek die mening uit dat die Bedryfsielkunde 'n spesifieke aspek van Personeelbestuur is. Of daar wel so 'n onderskeid bestaan word in hierdie artikel ontleed aan die hand van Whyte se definisie en beskouinge van Personeelbestuur en Bedryfsielkunde en die resente ontwikkelinge op die terrein van die Bedryf- en Organisasiesielkunde. Daar word tot die slotsom gekom dat daar wel geringe klemverskille bestaan, maar dat dit nie dieselfde is as die wat Whyte beklemtoon nie. Ten einde die gemeenskaplike doelstellings te bevorder, moet beide die ooreenkomste en verskille erken word en moet noue samewerking tussen Bedryf- en Organisasiesielkundiges en personeelbestuurders aangemoedig word.

  9. Splenic tuberculosis. Report of twelve cases; La tuberculose splenique

    Energy Technology Data Exchange (ETDEWEB)

    Adil, A.; Chikhaoui, N.; Ousehal, A.; Kadiri, R. [Centre Hospitalier Universitaire Ibn Rochd, Casablanca (Morocco)

    1995-12-31

    Tuberculosis of the spleen is not exceptional. The authors report ten cases which occurred with a predominance in young male adults. All patients had at least one other site of tuberculosis without any HIV infection. All patients had focal splenic lesions in the form of scattered hypo-echogenic and hypodense nodules. These nodules had a pseudo-tumor appearance in one case. CT-guided puncture was performed in one case. Splenic tuberculosis is not as rare as is sometimes thought. The CT-guided splenic puncture is now performed routinely and remains the ideal diagnostic approach. (authors). 9 refs., 5 figs.

  10. Die andersheid van Die verdwaalde land – die waarheid as storie vertel

    Directory of Open Access Journals (Sweden)

    M. Hattingh

    1993-05-01

    Full Text Available Die verdwaalde land was written by Abraham Phillips, a so-called Coloured man from a South African working class background; someone who has no knowledge of literary conventions. The question arises: how can such a text be read without its uniqueness being affected by biased preconceptions? This article shows that post-structurally inspired theories on colonial discourse reveal perspectives on the complexity within the simplicity of this story. In this analysis of Die verdwaalde land particular emphasis is placed on identifying the framing strategies through which images and presentations of the Self and Other are created. Literary conventions are exposed as mechanisms which demarcate meaning, which in principle do not differ much from the manipulative strategies which define identity in the real world.Irrespective of nationality and time the line at which light race meets dark is the line at which human sociality is found at the lowest ebb; and wherever that line conies into existence there arc found the darkest shadows which we humans have cast by our injustice and egoism across the earth. (Olive Schreiner - Thoughts on South Africa

  11. Twelve-month follow-up of left atrial appendage occlusion with Amplatzer Amulet.

    Science.gov (United States)

    Kleinecke, Caroline; Park, Jai-Wun; Gödde, Martin; Zintl, Konstantin; Schnupp, Steffen; Brachmann, Johannes

    2017-01-01

    The Amplatzer Amulet (St. Jude Medical, Minneapolis, MN, USA) is a second gen-eration Amplatzer device for left atrial appendage (LAA) occlusion (LAAO) for stroke prophylaxis in patients with atrial fibrillation. This research sought to assess the clinical performance of the Amplatzer Amulet device and in follow up for 12 months. In this single-center registry patients with atrial fibrillation and contraindication to oral anticoagulation underwent LAAO with the Amplatzer Amulet device. Follow-up was performed before discharge, by transesophageal echocardiography (TEE) after 6 weeks and telephone interview after 3, 6 and 12 months. Between October 2014 and August 2015 50 patients (76.1 ± 8.3 years; 30 male) were en-rolled. Procedural success was achieved in 49 (98%) patients. Major periprocedural adverse events were observed in 4 (8%) of patients: 1 device embolization, 2 pericardial effusions requiring pericardiocente-sis and 1 prolonged hospital stay due to retropharyngeal hematoma from the TEE probe. Follow-up TEE was available in 38 of 50 patients showing complete LAA sealing in all. 2 device-related thrombi were also documented. At 12-month follow-up 7 patients had died unrelated to the device. Ischemic stroke occurred in 3 patients. According to neurological examination two were classified as microangiopathic and not cardio-embolic. The other one could not be classified. Bleeding complications (5 minor, 3 major) were documented in 8 patients. Although minimizing procedure-related complications remains challenging, LAAO with the Amplatzer Amulet device showed high procedural success and excellent LAA sealing. (Cardiol J 2017; 24, 2: 131-138).

  12. Dying and death in some Roma communities: ethical challenges.

    Science.gov (United States)

    Roman, Gabriel; Gramma, Rodica; Enache, Angela; Pârvu, Andrada; Ioan, Beatrice; Moisa, Ştefana Maria; Dumitraş, Silvia; Chirita, Radu

    2014-04-01

    The Roma people have specific values, therefore their views and beliefs about illness, dying and death are important to be known for health care providers caring for members of this community. The aim of this qualitative study based on 48 semi-structured interviews with Roma patients and caregivers in communities in two regions of Romania was to examine their selfdescribed behaviors and practices, their experiences and perceptions of illness, dying and death. Five more important themes about the Roma people facing dying and death have been identified: (1) The perception of illness in the community as reason for shame and the isolation that results from this, as well as the tendency for Roma people to take this on in their self image; (2) The importance of the family as the major support for the ill/dying individual, including the social requirement that family gather when someone is ill/dying; (3) The belief that the patient should not be told his/her diagnosis for fear it will harm him/her and that the family should be informed of the diagnosis as the main decision maker regarding medical treatment; (4) The reluctance of the Roma to decide on stopping life prolonging treatment; (5) The view of death as 'impure'. These results can be useful for health care providers working with members of the Roma community. By paying attention to and respecting the Roma patients' values, spirituality, and relationship dynamics, the medical staff can provide the most suitable healthcare by respecting the patients' wishes and expectations.

  13. Der Einfluß der Herztransplantation auf die Partnerschaft als Faktor der Lebensqualität

    Directory of Open Access Journals (Sweden)

    Laederach-Hofmann K

    2000-01-01

    Full Text Available Eine terminale Herzkrankheit mit all ihren somatischen und psychosozialen Konsequenzen und deren Einflüssen auf die Lebensqualität belastet den Patienten und ebenso sein Umfeld, vorab seinen Partner. Das soziale Netz ist einer der wichtigsten Faktoren, der zu psychischer Stabilität beiträgt. Es hilft, Gefühle von Hilflosigkeit, Depression und Unsicherheit besser zu ertragen, vermindert die Ängstlichkeit und verbessert die Lebensqualität. Ziel dieser prospektiven Untersuchung war es, Angaben über den Einfluß einer Herztransplantation auf die Partnerschaftsbeziehung zu erhalten. Methoden: Von 26 Paaren wurden mittels der Familienbögen (FAM III, die 7 interaktionelle Dimensionen erfassen, Daten zu drei Zeitpunkten gesammelt: 1 wenn der Patient auf die Warteliste gesetzt wurde, 2 1 Jahr und 3 5 Jahre nach Transplantation. Zusätzlich wurde die Lebensqualität mit einem Globalmaß erfragt. Resultate: Im Verlauf einer Herztransplantation berichten beide, Patient und Partner, von einer generellen Verschlechterung der Partnerschaftsbeziehung. Ein Jahr nach Herztransplantation verschlechtert sich für die Patienten die Partnerschaftsbeziehung signifikant (Summenwert, p = 0,034. Dabei ist der wichtige Punkt die Verschlechterung der Emotionalität (p = 0,009, die einen Mangel an affektiver Kommunikation und eine Verschlechterung emotionaler Bedürfnisbefriedigung anzeigt. Fünf Jahre nach Herztransplantation ist der Summenwert unverändert, lediglich die Emotionalität hat sich geringradig verbessert (p = 0,032 im Vergleich zu 1 Jahr nach Herztransplantation. Ähnlich wie die Patienten geben auch deren Partner eine Verschlechterung im Summenwert des FAM III an (p = 0,0006. Allerdings fühlen sich die Partner noch in weiteren 4 von 7 Dimensionen beeinträchtigt, nämlich im Rollenhaushalt (p = 0,014, in der Kommunikation (p = 0,017, in der affektiven Beziehung (p = 0,020 und in den Werten und Normen (p = 0,021. Jedoch bleibt der für die Patienten

  14. Die sterwende kind in hospitaalvernand

    Directory of Open Access Journals (Sweden)

    Fredrika de Villiers

    1981-09-01

    Full Text Available Illness and death of a child is a crisis situation in the family, affecting all members. Parents experience certain universal problems such as denial, feelings of guilt and withdrawal. The dying child is usually aware of his situation and experiences fear and loneliness. He has diverse physical and psychological needs as a result of his illness which must be met by parents and nurses. In caring for the terminally ill child attention must be given to providing: a physical environment conducive to well-being; a consistent emotional climate; communication which should include therapeutic play; a therapeutic program in which various measures are taken to enhance acceptability; physical care where the child is encouraged to help himself as far as possible; psycological and spiritual care to allay his fears and anxiety.

  15. Ocular hypotensive effect, preservation of visual fields, and safety of adding dorzolamide to prostaglandin therapy for twelve months

    Directory of Open Access Journals (Sweden)

    Kenji Inoue

    2011-03-01

    Full Text Available Kenji Inoue1,3, Mieko Masumoto1,3, Masato Wakakura1, Goji Tomita2, On behalf of the Ochanomizu Ophthalmology Study Group31Inouye Eye Hospital, Tokyo, Japan; 2Department of Ophthalmology, Toho University School of Medicine, Tokyo, Japan; 3Ochanomizu Ophthalmology, Tokyo, JapanPurpose: To prospectively evaluate the safety, hypotensive effect, and preservation of visual fields of dorzolamide when added to latanoprost.Subjects and methods: This study included 46 patients (46 eyes with primary open-angle glaucoma who had been treated with latanoprost. Dorzolamide (1% was added to latanoprost, and the intraocular pressure (IOP was monitored before and after 3, 6, and 12 months. The mean deviation shown by Humphrey perimetry was compared before and after twelve months of treatment. Adverse reactions were monitored over the 12-month study period.Results: The mean baseline IOP was 17.2 ± 3.0 mmHg while those after 3, 6 and 12 months of treatment were 14.9 ± 3.0 mmHg, 14.5 ± 3.2 mmHg, and 14.6 ± 2.6 mmHg respectively (P < 0.0001, 1-ß(power = 0.9999571. The absolute reduction of IOP and the percent reduction were similar after 3, 6, and 12 months of treatment. The mean deviation on Humphrey perimetry was similar before and after twelve months of treatment. Three patients discontinued dorzolamide therapy due to elevation of IOP and one patient discontinued it because of adverse reactions.Conclusion: Dorzolamide is safe and effective when used for twelve months as add-on therapy to latanoprost for open-angle glaucoma.Keywords: dorzolamide, primary open-angle glaucoma, latanoprost 

  16. Lig op Satan en Satanisme vanuit die Nuwe Testament

    Directory of Open Access Journals (Sweden)

    F. J. van Rensburg

    1992-06-01

    Full Text Available In hierdie artikel word, in aansluiting by en as voorsetting van prof. Vosloo se "Lig op Satanisme vanuit die Ou Testament" ook in die Nuwe Testament lig op die Satan en Satanisme-verskynsel gesoek. Wat die aard van die inhoud van hierdie artikel betref, probeer ek doelbewus om die stof só aan te bied dat dit gemaklik tot die gemiddelde ernstige Bybelleser kommunikeer. Derhalwe is die aanpak nie akademies-wetenskaplik nie, maar populêr-wetenskaplik.

  17. Evaluation of permanent die coatings to improve the wear resistance of die casting dies. Final project report, January 1, 1995--April 30, 1997

    Energy Technology Data Exchange (ETDEWEB)

    Shivpuri, R.

    1997-09-18

    Die Casting dies are subject to severe service conditions during the die casting operation. While these severe conditions are necessary to achieve high production rates, they cause the dies which are commonly made of H13 die steel, to suffer frequent failures. The major die failure mechanisms are erosion or washout, Heat checking, soldering and corrosion. Due to their geometrical complexity, die casting dies are very expensive (some dies cost over a million dollars), and thus a large number of parts have to be produced by a die, to justify this cost and leverage the advantages of the die casting process (high production rates, low manpower costs). A potential increase in the die service life, thus has a significant impact on the economics of the die; casting operation. There are many ways to extend die life: developing new wear resistant die materials, developing new surface treatments including coatings, improving heat treatment of existing H13 dies, using better lubricants that can protect the die material, or modifying the die geometry and process parameters to reduce the intensity of wear. Of these the use of coatings to improve the wear resistance of the die surface has shown a lot of promise. Consequently, use of coatings in the die casting industry and their wide use to decrease die wear can improve significantly the productivity of shop operations resulting in large savings in material and energy usage.

  18. Development of vacuum die-casting process

    Institute of Scientific and Technical Information of China (English)

    Masashi Uchida

    2009-01-01

    The vacuum die-casting process, started 25 years ago in Japan, has been widely applied. This technology contributes very much to improvement of castings quality. The main factor causing the defects of die castings is the trapped air in the mold cavity, while the key technology of vacuum die-casting process is to avoid the trapped air effectively by evacuating the cavity before casting. At the same time, due to the shot speed and the casting pressure reduced in half, the service life of the die is prolonged and the productivity is enhanced, as well. Vacuum die-casting process is of great significance in improving the die castings quality and making up the shortcomings of super-high-speed shot casting.

  19. Amensie en demensie met verwysing na die intellek

    Directory of Open Access Journals (Sweden)

    P. C. W. Deppe

    1958-03-01

    Full Text Available ,,Es ist der Geist der sich den Kórper baut” het Goethe gesê en hy het daardeur die monistiese begrip in die psigiatrie beklemtoon. Dwarsdeur die eeue het die ontwikkelingsgeskiedenis van die mens maar telkens getoon hoedat daar by die mens veral, nie anders gedink kan word dan as 'n psigosomatiese eenheid nie. 

  20. MIDCAB Operationen in Wien - die ersten Erfahrungen

    Directory of Open Access Journals (Sweden)

    Czerny M

    1999-01-01

    Full Text Available Die sogenannte MIDCAB (minimal invasive direct coronary artery bypass Operation wurde als chirurgische Therapie der koronaren Eingefäßerkrankung in letzter Zeit kontroversiell diskutiert. Ihr klinischer Stellenwert ist weiterhin unklar. Im Zeitraum von April 1996 bis Mai 1998 wurde die MIDCAB-Operation an 57 Patienten an der Abteilung für Herz-Thorax Chirurgie, Universität Wien durchgeführt. Zielgefäße für eine chirurgische Revaskularisierung waren die LAD (n = 52 und die RCA (n = 5. Als arterieller Graft dienten die linke Art. mammaria interna (LAD-Bypass bzw. die Art. gastroepiploica dextra (RCA-Bypass. Als Zugänge wurden limitierte Schnittführungen gewählt, in 91% der Fälle die anterolaterale Thorakotomie und in 9% der subxyphoidale Zugang, die Anastomosierungen erfolgten am schlagenden Herzen ohne Herzlungenmaschine. In 52 Fällen wurde die LIMA (Left internal mammary artery mit der LAD anastomosiert. Bei 3 von 52 Patienten mußte wegen einer intramyokardialen LAD zu einer konventionellen Operation gewechselt werden, in 4 Fällen war eine Revision notwendig. In allen Fällen gab es keinen Todesfall und keinen perioperativen Infarkt. Bei 36 Patienten wurde eine postoperative Kontrollangiographie durchgeführt, es ergab sich eine primäre Offenheitsrate von 96%. In 5 Fällen wurde eine Anastomose zwischen GEA und RCA hergestellt. Es gab keine Konversion, keinen Todesfall und keinen Myokardinfarkt. Drei dieser Patienten wurden postoperativ nachangiographiert, die Bypässe waren gut durchgängig. Zum derzeitigen Zeitpunkt sind alle 57 Patienten klinisch symptomfrei. Nach Überwindung von anfänglichen technischen Schwierigkeiten sind die Ergebnisse mit der MIDCAB-Operation sehr gut. Als potentielles Patientenkollektiv für die Zukunft scheinen sich vor allem Patienten nach multiplen kardiologischen Interventionen an der LAD bzw. der RCA anzubieten.

  1. Hemofilie onder die nasate van koningin Victoria

    Directory of Open Access Journals (Sweden)

    Francois P. Retief

    2013-03-01

    Full Text Available Hierdie studie bespreek die uitwerking van die sogenaamde Victoriaanse hemofilie op Europese koningshuise gedurende die negentiende en twintigste eeu. Hemofilie as molekulêre defek word verduidelik en die kliniese beeld van die siekte word aangedui. ’n Bespreking van toepaslike terapeutiese ingrepe volg. Dan word ’n historiese oorsig verskaf van die verspreiding van Victoriaanse hemofilie vanaf koningin Victoria (Britse monarg, 1837–1901 via sommige van haar dogters na ander lede van die Britse koningshuis en ook na die Duitse, Russiese en Spaanse koningshuise. Elf bevestigde gevalle van hemofilie onder lede van koningin Victoria se nageslag word vermeld, asook drie ander moontlike gevalle van die siekte. Die effek van hemofilie op die verloop van die geskiedenis word ook ondersoek.Haemophilia amongst the descendants of Queen Victoria. This study discusses the impact of ‘Victorian haemophilia’ on the royal houses of Europe during the 19th and 20th centuries. Haemophilia as a molecular defect is explained and the clinical picture of the condition is indicated. Applicable therapeutic interventions also receive attention. Next, an historical review is provided of how ‘Victorian haemophilia’ spread from Queen Victoria (British monarch, 1837–1901 via some of her daughters to other members of the British royal family and also to the royal houses of Germany, Russia and Spain. Eleven confirmed cases of haemophilia amongst the descendants of Queen Victoria are mentioned, as well as three other possible cases. The effect of haemophilia on the course of history is also investigated.

  2. Die Schlaganfall-Datenbank für Wien - Ziele und Methodik

    Directory of Open Access Journals (Sweden)

    Lalouschek W

    2001-01-01

    Full Text Available 1998 wurde die "Schlaganfall-Datenbank für Wien" (SDBW etabliert, an der neun neurologische Abteilungen Wiens teilnehmen. Die vorliegende Arbeit beschreibt die Ziele und Methodik der SDBW. Die Ziele der SDBW sind: 1. die Dokumentation der Struktur-, Prozeß- und Ergebnisqualität medizinischer Einrichtungen und die Schaffung einer Grundlage, um diese zielgerichtet zu optimieren; 2. Verwendung der erhobenen Daten zur Planung und Durchführung gesundheitspädagogischer Programme; 3. die Verbesserung oder Erstellung von Algorithmen, um die klinische Entscheidungsfindung zu verbessern und Prädiktoren des Ergebnisses nach einem zerebrovaskulären Ereignis zu definieren; 4. die Dokumentation von Veränderungen diagnostischer und therapeutischer Maßnahmen innerhalb eines bestimmten Zeitraumes; 5. die Formulierung von Hypothesen zu Ätiologie, Pathophysiologie, klinischem Verlauf und Ergebnis nach einem zerebrovaskulären Ereignis sowie Definition derjenigen Faktoren, welche diese Parameter beeinflussen. Seit Oktober 1998 werden alle PatientInnen mit der Verdachtsdiagnose einer transitorischen ischämischen Attacke (TIA oder eines Schlaganfalles, welche an einem der teilnehmenden Zentren innerhalb von 72 Stunden nach Symptombeginn aufgenommen wurden, in die SDBW eingeschlossen. Alle PatientInnen werden prospektiv gemäß standardisierten, detaillierten Protokollen dokumentiert. Die erhobenen Daten umfassen: demographische Parameter; medizinische, insbesondere vaskuläre Anamnese; vaskuläre Risikofaktoren; Ergebnisse von Laboruntersuchungen und technischen Zusatzuntersuchungen (inkl. zerebrovaskulären, kardiologischen und neuroradiologischen Parametern; eine detaillierte Dokumentation der pharmakologischen und nichtpharmakologischen Behandlung; Faktoren, welche den Zeitraum vom Symptombeginn bis zum Eintreffen im Spital und Beginn der Therapie beeinflussen; eine klinische und ätiologische Klassifikation gemäß definierten Kriterien; neurologische

  3. The impact of alcoholics anonymous on other substance abuse-related twelve-step programs.

    Science.gov (United States)

    Laudet, Alexandre B

    2008-01-01

    This chapter explores the influence of the AA model on self-help fellowships addressing problems of drug dependence. Fellowships that have adapted the twelve-step recovery model to other substances of abuse are reviewed; next similarities and differences between AA and drug-recovery twelve-step organizations are examined; finally, we present empirical findings on patterns of attendance and perceptions of AA and Narcotics Anonymous (NA) among polydrug-dependent populations, many of whom are cross-addicted to alcohol. Future directions in twelve-step research are noted in closing.

  4. Anfangen, sich die Welt anders vorzustellen

    Directory of Open Access Journals (Sweden)

    Sabine Fuchs

    2006-11-01

    Full Text Available Der Sammelband Butler Matters bezeugt Judith Butlers außerordentliche Bedeutung für feministische und queere Studien und Forschung. In elf Beiträgen wird Butlers (frühes Werk von Gender Trouble und Bodies That Matter über Excitable Speech bis zu The Psychic Life of Power betrachtet und sein weit reichender Einfluss quer durch die wissenschaftlichen Disziplinen nachgewiesen. Dargestellt werden auch die kontroverse Rezeption von Butlers Werk sowie die politischen Wirkungen von Butlers Denken. Besonders anregend ist ein zweiteiliges Interview mit Judith Butler, in dem sie auf ein breites Spektrum von Fragen eingeht, die auch wichtige Themen ihrer aktuelleren Werke betreffen.

  5. Die Osteonekrose des Hüftgelenks

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    Meizer R

    2007-01-01

    Full Text Available Die Osteonekrose des Hüftgelenkes entsteht durch eine Ischämie des Hüftkopfes. Diese kann traumatisch bedingt sein oder durch Risikofaktoren wie Kortikosteroide, Alkohol, Blutgerinnungsstörungen, Schwangerschaft sowie entzündliche und systemische Erkrankungen begünstigt werden. Als Sonderform der avaskulären Nekrose wird das Knochenmarködemsyndrom diskutiert. In der Diagnostik hat sich die Magnetresonanztomographie insbesondere wegen der Erfassung des reversiblen Frühstadiums zur Methode der Wahl entwickelt. Die Stadieneinteilung der ARCO unterscheidet zwischen Initialstadium (Stadium 0, reversiblem und irreversiblem Frühstadium (1 und 2, Übergangsstadium (3 und Spätstadium (4. Der Erfolg der verschiedenen Behandlungsmöglichkeiten hängt sehr vom Stadium bei Diagnosestellung ab. Im Frühstadium sowie beim Knochenmarködemsyndrom hat sich die Therapie mit dem Prostazyklinanalogon Iloprost bewährt und die Behandlung durch Hüftkopfbohrung in den Hintergrund gedrängt. Erfolgversprechend sind weiters die Therapien mit Enoxaparin und Bisphosphonaten. In fortgeschrittenen Stadien sind Umstellungsosteotomien und die Verwendung von Knochentransplantaten möglich. Bei großen Läsionen im Spätstadium ist die Hüftendoprothetik die Therapie der Wahl.

  6. Goethe und die Kindsmörderin

    Directory of Open Access Journals (Sweden)

    Ursula Künning

    2005-11-01

    Full Text Available Am 28. November 1783 wurde in Weimar die vierundzwanzigjährige Dienstmagd Johanna Catharina Höhn wegen der Tötung ihres neugeborenen Kindes hingerichtet. Maßgeblich beteiligt am Todesurteil war Johann Wolfgang von Goethe als Mitglied des Beratungsgremiums des Herzogs von Weimar Carl Gustav. Äußerst kritisch beurteilt Rüdiger Scholz in seinem Text die Goetherezeption, die bis in die Gegenwart hinein den Schriftsteller idealisiert und Rechtfertigungen für seine Mitwirkung am Schicksal der Johanna Catharina Höhn sucht.

  7. Die religieuse grondslag van ons omgewingskrisis

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    M.L. Hugo

    1975-03-01

    Full Text Available Die mensdom is besig om sy habitat op so ’n wyse te misbruik en te besoedel dat sy toekoms op hierdie planet duister is. In die woorde van White “.. surely no creature other than man has ever managed to foul its nest in such short order”. Hierdie stelling is nie oordrewe nie soos blyk uit die vloedgolf van literatuur wat tans verskyn oor hierdie kwessie. Miskien die sprekendste titel onder hierdie bronne wat onlangs verskyn het, is dié onder redaksie van Anderson: “OMEGA: Murder of the Ecosystem and Suicide of Man.”

  8. Die samestelling en evaluering van 'n groepfasiliteringskursus

    Directory of Open Access Journals (Sweden)

    S. Rothmann

    1997-06-01

    Full Text Available The development and evaluation of a group facilitation course. The personality profile of a group facilitator is conceptualised as consisting of group knowledge and skills, interpersonal effectiveness, and personality traits. A group facilitation course directed at the stimulation of this profile was developed. The course improved the skills of praticipants to respond to process issues in a group, as well as their knowledge of group facilitation. Their empathy, respect, genuineness and concreteness improved significantly. Although changes in spontaneity, time competence and existentiality were found after completing the course, these changes cannot be ascribed to the course. Organisational factors may impede the development of the personality traits of the group facilitator. Opsomming Die persoonlikheidsprofiel van die groepfasiliteerder word gekonseptualiseer as groepkennis en -vaardighede, interpersoonike effektiwiteit, en persoonlikheidskenmerke. 'n Groepfasiliteringskursus gerig op die stimulering van hierdie profiel is ontwikkel. Die kursus het daartoe bygedra om deelnemers se vaardigheid om op prosesaangeleenthede in 'n groep te reageer, asook om hul kennis van groepfasilitering te verbeter. Deelnemers se empatie, respek, egtheid en konkreetheid het beduidend toegeneem. Alhoewel veranderinge ten opsigte van spontaneïteit, tydsbewustheid en eksistensialiteit gevind is, kan hierdie veranderinge nie aan die kursus toegeskryf word nie. Organisasiefaktore kan struikelblokke wees in die weg van die ontwikkeling van die persoonliheidskenmerke van die groepfasiliteerder.

  9. DIE GESKIEDENIS VAN DIE SUID-AFRIKAANSE MILITÊRE AKADEMIE, 1950 - 1990

    Directory of Open Access Journals (Sweden)

    G.E. Visser

    2012-02-01

    part of the debate. Also in dispute, was the location of the Academy at Saldanha, rather than in the military heart-land in Pretoria. By interpreting the academic training needs of the Defence Force correctly and positioning itself accordingly, the Academy survived that crisis. Thereafter, the Academy time and again adapted to the changing military and socio-political environment and strove towards ever increasing relevance to the Defence Force. In this way female and non-European students were admitted to the Military Academy, whilst the way was also paved for the admittance of students from other African states. In anticipation of the new political dispensation in South Africa, a concerted effort was launched in 1990 to make the student body more representative of the South Africa population in terms of race and sex. The Military Academy has through the years established itself as a credible military academic institution and has made a significant contribution towards military professionalism in South Africa. By 1990 it favourably positioned itself to continue that role in future. Though forming only a small percentage of the total officer corps, the Academy graduates have gradually been distributed at all levels of the' officer corps and have dominated the top posts in the SA Defence Force since the early 1970's. They were consequently well placed in 1990 to play a significant role in preparing the Defence Force for the so-called "New South Africa". ****** AFRIKAANSE OPSOMMING: Die Suid-Afrikaanse Militêre Akademie is op 1 April 1950 gestig met die doel om die militêrakademiese opleiding van kandidaatoffisiere hier te lande op dieselfde peil as in die buiteland te bring en dit terselfdertyd tot universiteitsvlak te verhef. Die Minister van Verdediging, F.C. Erasmus, wou egter ook die Akademie gebruik as instrument om die Afrikaner sy regmatige plek, naas Engelssprekendes, in die offisierskorps te laat inneem en sodoende die oorwegend Britse karakter van die

  10. Review of Pasteurella Multocida Infections over a Twelve-Year Period in a Tertiary Care Hospital

    Directory of Open Access Journals (Sweden)

    Athanasia Christidou

    2005-01-01

    Full Text Available The aim of this study was to present the epidemiological, clinical and microbiological data, as well as the management and the outcome of 13 patients with documented Pasteurella multocida infections, diagnosed in the University hospital of Crete, Greece, between 1993 and 2004. Most patients (62% were >70 years of age. Respiratory tract infections were most commonly encountered (61.5%, followed by soft-tissue infections (30.8% and septicemia (7.7 %. Underlying diseases included malignancies, bullous pemphigoid, mitral valve stenosis, coronary disease, chronic obstructive pulmonary disease and intracranial hemorrhage. Antibiotic sensitivity testing showed that all P. multocida isolates were susceptible to beta-lactams, quinolones, chloramphenicol, tetracycline and trimethoprim/sulfamethoxazole. Antibiotics were administered to all 13 patients and a clinical response was observed in 77% of them. The overall mortality rate was 23% (3/13 but only 15.4% (2/13 died from the infection. Although rare, P. multocida infections should be suspected in patients reporting animal exposure, particularly in those with chronic underlying diseases.

  11. Ideologiese normverplasings en die Afrikaanse handwoordeboek van die negentigerjare

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    A. Carstens

    1995-05-01

    Full Text Available Ideological norm replacement and the Afrikaans desk dictionary of the ninetiesIn South Africa the past decade has been marked by extensive sociopolitical changes and by concomitant linguistic changes. These changes may be regarded as instances of norm replacement - a process during the course of which a norm or a set of norms is gradually replaced by another norm or set of norms. It is maintained that the standard synchronic dictionaries of a language not only have the obligation to reflect lexicalised norm replacements, but also to make projections with regard to future use. Two standard synchronic desk dictionaries of Afrikaans, namely the eighth edition of Verklarende Afrikaanse Woordeboek (1992 and the third edition of Verklarende Handwoordeboek van die Afrikaanse Taal (1994 are explored with special regard to their reflection of norm replacements within the domains of race and political ideology. It is shown that the compilers of these dictionaries consciously and sincerely aimed at removing all racial bias but that they failed to record the diversity of meaning within the political lexicon and the semantic shifts which have occurred within that lexicon during the past decade.

  12. Verskyningsvorme van die Simbolisme in die ouer Afrikaanse vertelkuns

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    H. Roos

    1990-05-01

    Full Text Available As the Symbolist movement has primarily been linked to the poetic mode, the association of symbolism with prose writing, and particularly with traditional Afrikaans prose, raises many questions, From the writings of older critics it appears that whereas they did identify symbolic patterns in the work of contemporaries, the presence of a specific Symbolist influence is either not recognized at all, or played down and evaluated negatively. However, several of the early authors themselves, e.g. Leipoldt, Grosskopf and Marais, referred to, or admitted to being influenced by the great 19th-century Symbolist poets. The most marked example of Symbolist writing is evident in the short stories of Marais (“Die Reënbul” and Van Melle (Denker kom kyk. In all the cases where the symbolist influence can be traced, several common characteristics are evident: the authors remained outside the mainstream of traditional Afrikaans prose writing, the lyrical tone and a decadent mood dominate, and in these early works signs of the innovative “Sestiger” prose are already evident.

  13. Handelinge in die erediens: Die verryking van die liturgie deur musiek

    Directory of Open Access Journals (Sweden)

    Elsabé Kloppers

    2005-10-01

    Full Text Available Actions in the worship service: Enriching liturgy through musicThe worship service in the Reformed Churches in South Africa has of late come under pressure. On the one hand it is experienced as too rigid and “traditional”. On the other hand superficial forms of renewal create tension. In this article the worship service and the meaning of the liturgical actions in the worship service of the Afrikaans Reformed Churches are discussed, and related to world-wide ecumenical tendencies. It is argued that certain liturgical actions are a necessary part of the ritual of the worship service. The structure needs inner logic, although there should also be some degree of flexibility. Hymns and music offer the means for a more creative presentation of liturgical actions and traditional forms. Suggestions to enrich the liturgy through the use of hymns and liturgical forms in the Liedboek van die Kerk (2001 are offered.

  14. Gambaran Stage of Dying pada Pasien Guillain Barre Syndrome (GBS)

    OpenAIRE

    Sembiring, Mona Sriukur

    2016-01-01

    Guillain Barre Syndrome (GBS) is a rare chronic disease. GBS can eventually cause paralysis and damage the body systems, patient can not move their body and have difficulty performing the daily activity. The exact causes of Guillain-Barre syndrome are not known and the cure has not been found (Parry & Steinberg, 2007). Patient with GBS may experience difficulties in daily living and feel that she is going to die. Patient will refuse to accept the death and get angry with God. Patients with ch...

  15. Twelve tips on teaching and learning humanism in medical education.

    Science.gov (United States)

    Cohen, Libby Gordon; Sherif, Youmna Ashraf

    2014-08-01

    The teaching of humanistic values is recognized as an essential component of medical education and continuing professional development of physicians. The application of humanistic values in medical care can benefit medical students, clinicians and patients. This article presents 12 tips on fostering humanistic values in medical education. The authors reviewed the literature and present 12 practical tips that are relevant to contemporary practices. The tips can be used in teaching and sustaining humanistic values in medical education. Humanistic values can be incorporated in formal preclinical environments, the transition into clinical settings, medical curricula and clinical clerkships. Additionally, steps can be taken so that medical educators and institutions promote and sustain humanistic values.

  16. ‘n Vergelykende histomorfologiese assessering van die testis van twee Clarias spesies van die Okavango Delta, Botswana

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    M.L. Mokae

    2012-03-01

    Full Text Available Die testis van twee Clarias species wat in die Okavango Delta voorkom, is histomorfologiesgeassesseer om die verskil in struktuur te beskryf, omdat die twee spesies se testiskleur verskilmet die Clarias ngamensis ‘n swart testis en die Clarias gariepinus ‘n roomkleurige testis.

  17. Kontekstuele bepalers by die beplanning van skoolwoordeboeke

    Directory of Open Access Journals (Sweden)

    Herman L. Beyer

    2011-10-01

    Full Text Available

    OPSOMMING: Die doel van hierdie artikel is om tot die metaleksikografiese gesprek oor skoolwoordeboeke as 'n tipe pedagogiese woordeboek by te dra. Die fokus is op kontekstuele bepalers wat by die beplanning van skoolwoordeboeke verreken behoort te word: Binne die konteks van 'n veeltalige Namibië word enkele onderwyskundige sisteme verken wat 'n impak op die ontwerp van gedrukte skoolwoordeboeke vir die sekondêre skoolfase kan hê, naamlik skoolkurrikula, die nasionale taalbeleid vir skole en die beleid van leerdergerigte onderwys. Hierdie artikel voer ook aan dat die voor die hand liggende teikengebruiker van 'n skoolwoordeboek, naamlik die leerder, nie die enigste teikengebruiker is nie: Die onderwyser word as medeteikengebruiker gestel wanneer dit by die gebruik van woordeboeke in die onderrigleersituasie kom. Verskillende tipes gevalle van woordeboekgebruik in die mikrokonteks van die onderrigleersituasie word onderskei, naamlik woordeboekonderrig, woordeboekgeïntegreerde taalonderrig en woordeboekgeondersteunde taalonderrig. Hierdie tipes gebruik behoort komponente van 'n woordeboekpedagogie te wees, wat uiteindelik behoort te lei tot outonome woordeboekgebruik en die gepaardgaande vestiging van 'n individuele woordeboekkultuur by die leerder. Die leksikograaf moet al hierdie aspekte inreken wanneer 'n skoolwoordeboek beplan word ten einde die nodige leksikografiese vernuwing in te voer. Enkele voorstelle vir sodanige vernuwings en vir verdere navorsing word ten slotte aangebied.

    Sleutelwoorde: GEBRUIKERSGERIGTE LEKSIKOGRAFIE, KONTEKS, LEERDER, LEERDERGERIGTE ONDERWYS, LEERWOORDEBOEK, LEKSIKOGRAAF, METALEKSIKOGRAFIE, NASLAANWOORDEBOEK, ONDERWYSER, PEDAGOGIESE WOORDEBOEK, SISTEEM, SKOOLWOORDEBOEK, TAALBELEID, TEIKENGEBRUIKER, WOORDEBOEKGEBRUIK, WOORDEBOEKGEÏNTEGREERDE TAALONDERRIG, WOORDEBOEKONDERSTEUNDE TAALONDERRIG, WOORDEBOEKONDERRIG, WOORDEBOEKPEDAGOGIE

    ABSTRACT: Contextual Determiners in the Planning of School

  18. Clinical requirements of aortic imaging; Klinische Anforderungen an die Bildgebung der Aorta

    Energy Technology Data Exchange (ETDEWEB)

    Boeckler, D.; Hylik-Duerr, A.; Klemm, K. [Ruprecht-Karls-Universitaet Heidelberg, Klinik fuer Gefaesschirurgie,Vaskulaere und Endovaskulaere Chirurgie, Heidelberg (Germany); Tengg-Kobligk, H. von; Kauczor, H.U. [Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Abteilung Radiologie, Heidelberg (Germany); Lopez-Benitez, R. [Ruprecht-Karls-Universitaet Heidelberg, Abteilung Radiodiagnostik, Heidelberg (Germany)

    2007-11-15

    Modern imaging modalities, especially noninvasive cross-sectional imaging techniques, have advanced dramatically in recent years and are now the backbone of pre- and postoperative evaluation of aortic pathologies. The planning in particular, but also the aftercare following endovascular aortic reconstructions, make heavy demands on physicians. It is necessary to select the method of examination that is best suited to the pathology concerned and to apply it to the patient in an individual manner. Ultrasound is the examination of choice for screening and follow-up of infrarenal aneurysms. Transesophageal echocardiography and magnetic resonance angiography are used in diagnosis, in intraoperative navigation during the implantation of endografts and in follow-up of patients with thoracic aortic aneurysms and aortic dissections who have undergone conservative treatment, with very high sensitivity and specificity. The use of MRA is restricted by the long time needed for an examination, metal artifacts and limited availability. DSA has been largely superseded in the diagnosis of aortic pathologies by CTA, but as yet retains its role in intraoperative imaging of the anchorage regions of endoprostheses. Selective demonstration of postoperative internal leaks with subsequent therapeutic embolization is a further area of use for DSA. CTA, including so-called image postprocessing, has taken over the prime role in imaging of the aorta. Disease-specific diagnostic algorithms are useful and necessary in day-to-day clinical practice. (orig.) [German] Die moderne Bildgebung, insbesondere die nichtinvasive Schnittbildgebung, hat sich in den letzten Jahren dramatisch weiterentwickelt und stellt mittlerweile die Basis fuer die prae- und postoperative Diagnostik aortaler Pathologien dar. Insbesondere die Planung, aber auch die Nachsorge endovaskulaerer Aortenrekonstruktionen stellen sehr hohe Anforderungen an den Diagnostiker und Therapeuten. Aus der Vielzahl der bestehenden

  19. Oncology nurses' identification with their responsibilities and negative experience in caring for dying cancer patients%肿瘤科护士对照顾终末期癌症患者的职责认同与负性感受研究

    Institute of Scientific and Technical Information of China (English)

    陆宇晗; 国仁秀; 刘莉

    2011-01-01

    目的:了解肿瘤科护士对照顾终末期癌症患者的态度.方法:采用自行编制的"护士照顾终末期癌症患者的态度评估量表",对全国19家医院的463名肿瘤科护士进行调查,内容包括护士对照顾终末期癌症患者的职责认同程度以及工作中的负性感受两个维度,每个维度均包括症状控制、心理辅导以及家属支持3个方面的测量.结果:①护士对症状控制、心理辅导以及家属支持3方面的职责普遍认同,但在心理辅导方面.对帮助患者应对疾病状况和死亡的职责的认同分值不高,存在不确定性.②护士在3方面的实践中负性感受均较高,其中在帮助家属应对悲伤过程中的负性感受最强,对症状控制的无能为力感受次之.心理辅导方面,护士在帮助患者应对当前疾病状况和谈论死亡问题上感到困难.③护士在症状控制和心理辅导两方面的职责认同程度与工作中的负性感受呈负相关.结论:肿瘤姑息护理的继续教育仍需进一步加强,帮助更多的肿瘤科护士明确职责,更新理念,提高专科护理知识水平和能力,才能为终末期癌症患者提供更加专业、有效的护理,同时也有助于减轻工作中的负性感受和压力.%Objective: To explore oncology nurses' attitudes on caring for dying cancer patients. Methods: Totally 463 oncology nurses from 19 nationwide hospitals were investigated by a self-designed scale. The scale was comprised of two subscales to evaluate respondents' agreement with their responsibilities and negative experience in caring for dying cancer patients. There were three dimensions in each subscale, including symptom management, psychological counseling and family support. Results: ① Generally oncology nurses agreed with their responsibilities in the three aspects of caring for dying patients. But lower scores were reported in the responsibility of helping patients to deal with dying and death. ② Oncology

  20. Hospice Care for Children With Cancer: Where Do These Children Die?

    Science.gov (United States)

    Thienprayoon, Rachel; Lee, Simon C; Leonard, David; Winick, Naomi

    2015-07-01

    Hospice is an important provider of end of life care; many children who die of cancer enroll in hospice programs. How frequently such children remain in hospice to die at home, or disenroll from hospice and die in the hospital, has not been described. A child's location of death has important implications for quality of life and parental adaptation. This represents a subanalysis of a retrospective study of 202 consecutive oncology patients who died at a single center between January 1, 2006 and December 31, 2010. Of 95 children who enrolled in hospice, 82 had known location of death. Sixty (73%) died at home or an inpatient hospice unit, 15 (18%) died in the oncology unit, 5 (6%) died in the intensive care unit, and 2 (2%) died in the emergency department. The median length of hospice services was 41 days, twice the national median of 21 days reported in adults. One quarter of children disenrolled from hospice care, ultimately dying in an acute care setting. Further studies are warranted to explore the hospice experience in children, and to address modifiable factors that may impact a family's choice to withdraw from hospice care.