Sample records for abschlussbericht ueber die

  1. On the Law of Inertia. Translation of: Ueber das Beharrungsgesetz

    NASA Astrophysics Data System (ADS)

    Lange, Ludwig

    2014-04-01

    This article is a translation of Ludwig Lange: "Ueber das Beharrungsgesetz" in: Berichte ueber Verhandlungen der Koenigl. Saechsischen Gesellschaft der Wissenschaften, math.-physik. Klasse (Leipzig, 1885), SS. 333-351. Translated by Herbert Pfister, Institut für Theoretische Physik, Universität Tübingen, Auf der Morgenstelle 14, 72076 Tübingen, Germany; herbert.pfister@uni-tuebingen.de. Kind assistance by Julian Barbour is acknowledged.

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    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 tiltmore » 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.« less

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

    NASA Astrophysics Data System (ADS)

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

    2015-10-01

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

  4. Packaged die heater

    DOEpatents

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

    2011-06-21

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

  5. SPHERICAL DIE

    DOEpatents

    Livingston, J.P.

    1959-01-27

    A die is presented for pressing powdered materials into a hemispherical shape of uniforin density and wall thickness comprising a fcmale and male die element held in a stationary spaced relation with the space being equivalent to the wall thickness and defining the hemispherical shape, a pressing ring linearly moveable along the male die element, an inlet to fill the space with powdered materials, a guiding system for moving the pressing ring along the male die element so as to press the powdered material and a heating system for heating the male element so that the powdered material is heated while being pressed.

  6. Die Soldering in Aluminium Die Casting

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    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-richmore » 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.« less

  7. HIGH PRESSURE DIES

    DOEpatents

    Wilson, W.B.

    1960-05-31

    A press was invented for subjecting specimens of bismuth, urania, yttria, or thoria to high pressures and temperatures. The press comprises die parts enclosing a space in which is placed an electric heater thermally insulated from the die parts so as not to damage them by heat. The die parts comprise two opposed inner frustoconical parts and an outer part having a double frustoconical recess receiving the inner parts. The die space decreases in size as the inner die parts move toward one another against the outer part and the inner parts, though very hard, do not fracture because of the mode of support provided by the outer part.

  8. Influence of die geometry and material selection on the behavior of protective die covers in closed-die forging

    NASA Astrophysics Data System (ADS)

    Yu, Yingyan; Rosenstock, Dirk; Wolfgarten, Martin; Hirt, Gerhard

    2016-10-01

    Due to the fact that tooling costs make up to 30% of total costs of the final forged part, the tool life is always one main research topic in closed-die forging [1]. To improve the wear resistance of forging dies, many methods like nitriding and deposition of ceramic layers have been used. However, all these methods will lose its effect after a certain time, then tool repair or exchange is needed, which requires additional time and costs. A new method, which applies an inexpensive and changeable sheet metal on the forging die to protect it from abrasive wear, was firstly proposed in [2]. According to the first investigation, the die cover is effective for decreasing thermal and mechanical loads, but there are still several challenges to overcome in this concept, like wrinkling and thinning of the die cover. Therefore, an experimental study using different geometries and die cover materials is presented within this work. The results indicate the existence of feasible application cases of this concept, since conditions are found under which a die cover made of 22MnB5 still keeps its original shape even after 7 forging cycles.

  9. Die Sonne.

    NASA Astrophysics Data System (ADS)

    der Time-Life Bücher, Redaktion

    Contents: 1. Das Antlitz der Sonne. Ein kosmisches Kraftwerk. 2. Erforschung des Innern. Die Beobachtung des Zentralgestirns. 3. Der unstete Nachbar. Geschenke des Sonnenlichts. 4. Ein endloser Partikelstrom. Die Kraft eines solaren Sturms.

  10. Die singulation method

    DOEpatents

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

    2013-06-11

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

  11. Die singulation method

    DOEpatents

    Swiler, Thomas P [Albuquerque, NM; Garcia, Ernest J [Albuquerque, NM; Francis, Kathryn M [Rio Rancho, NM

    2014-01-07

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

  12. The thermal fatigue resistance of H-13 Die Steel for aluminum die casting dies

    NASA Technical Reports Server (NTRS)

    1982-01-01

    The effects of welding, five selected surface coatings, and stress relieving on the thermal fatigue resistance of H-13 Die Steel for aluminum die casting dies were studied using eleven thermal fatigue specimens. Stress relieving was conducted after each 5,000 cycle interval at 1050 F for three hours. Four thermal fatigue specimens were welded with H-13 or maraging steel welding rods at ambient and elevated temperatures and subsequently, subjected to different post-weld heat treatments. Crack patterns were examined at 5,000, 10,000, and 15,000 cycles. The thermal fatigue resistance is expressed by two crack parameters which are the average maximum crack and the average cracked area. The results indicate that a significant improvement in thermal fatigue resistance over the control was obtained from the stress-relieving treatment. Small improvements were obtained from the H-13 welded specimens and from a salt bath nitrogen and carbon-surface treatment. The other surface treatments and welded specimens either did not affect or had a detrimental influence on the thermal fatigue properties of the H-13 die steel.

  13. Dimensional control of die castings

    NASA Astrophysics Data System (ADS)

    Karve, Aniruddha Ajit

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

  14. Assisted Dying & Disability.

    PubMed

    Riddle, Christopher A

    2017-07-01

    This article explores at least two dominant critiques of assisted dying from a disability rights perspective. In spite of these critiques, I conclude that assisted dying ought to be permissible. I arrive at the conclusion that if we respect and value people with disabilities, we ought to permit assisted dying. I do so in the following manner. First, I examine recent changes in legislation that have occurred since the Royal Society of Canada Expert Panel on End-of-Life Decision-Making report, published in this journal. I suggest that these changes are likely to only strengthen opposition to assisted dying from disability rights activists and people with disabilities. Second, I focus on respect for people with disabilities and in particular, respect for their autonomy and decision-making abilities. Third, I explore the opposition to assisted dying that focuses on risk and the vulnerability of people with disabilities. Here I suggest that this risk ought not to be of special concern. Ultimately, I conclude that upholding respect for the disabled requires the legalization of assisted dying, rather than the denial of access in a misguided effort to protect people with disabilities. © 2017 John Wiley & Sons Ltd.

  15. Micromechanical die attachment surcharge

    DOEpatents

    Filter, William F.; Hohimer, John P.

    2002-01-01

    An attachment structure is disclosed for attaching a die to a supporting substrate without the use of adhesives or solder. The attachment structure, which can be formed by micromachining, functions purely mechanically in utilizing a plurality of shaped pillars (e.g. round, square or polygonal and solid, hollow or slotted) that are formed on one of the die or supporting substrate and which can be urged into contact with various types of mating structures including other pillars, a deformable layer or a plurality of receptacles that are formed on the other of the die or supporting substrate, thereby forming a friction bond that holds the die to the supporting substrate. The attachment structure can further include an alignment structure for precise positioning of the die and supporting substrate to facilitate mounting the die to the supporting substrate. The attachment structure has applications for mounting semiconductor die containing a microelectromechanical (MEM) device, a microsensor or an integrated circuit (IC), and can be used to form a multichip module. The attachment structure is particularly useful for mounting die containing released MEM devices since these devices are fragile and can otherwise be damaged or degraded by adhesive or solder mounting.

  16. Sputtered protective coatings for die casting dies

    NASA Technical Reports Server (NTRS)

    Mirtich, M. J.; Nieh, C.-Y.; Wallace, J. F.

    1981-01-01

    Three experimental research designs investigating candidate materials and processes involved in protective die surface coating procedures by sputter deposition, using ion beam technologies, are discussed. Various pre-test results show that none of the coatings remained completely intact for 15,000 test cycles. The longest lifetime was observed for coatings such as tungsten, platinum, and molybdenum which reduced thermal fatigue, but exhibited oxidation and suppressed crack initiation only as long as the coating did not fracture. Final test results confirmed earlier findings and coatings with Pt and W proved to be the candidate materials to be used on a die surface to increase die life. In the W-coated specimens, which remained intact on the surface after thermal fatigue testing, no oxidation was found under the coating, although a few cracks formed on the surface where the coating broke down. Further research is planned.

  17. Herausforderungen durch die deutsche Wiedervereinigung

    NASA Astrophysics Data System (ADS)

    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.

  18. Displaced capillary dies

    DOEpatents

    Kalejs, Juris P.; Chalmers, Bruce; Surek, Thomas

    1982-01-01

    An asymmetrical shaped capillary die made exclusively of graphite is used to grow silicon ribbon which is capable of being made into solar cells that are more efficient than cells produced from ribbon made using a symmetrically shaped die.

  19. Displaced capillary dies

    DOEpatents

    Kalejs, Juris P.; Chalmers, Bruce; Surek, Thomas

    1984-01-01

    An asymmetrical shaped capillary die made exclusively of graphite is used to grow silicon ribbon which is capable of being made into solar cells that are more efficient than cells produced from ribbon made using a symmetrically shaped die.

  20. Wissenschaft, die unsere Kultur verändert. Tiefenschichten des Streits um die Evolutionstheorie

    NASA Astrophysics Data System (ADS)

    Patzelt, Werner J.

    Die Evolutionstheorie ist eine der erfolgreichsten wissenschaftlichen Theorien. Sie erlaubt es, unsere Herkunft zu verstehen und riskante Merkmale gerade der menschlichen Spezies zu begreifen. Zugleich ist die Evolutionstheorie eine der umstrittensten Theorien. Das liegt nicht an ihrer empirischen Tragfähigkeit, sondern an ihrem Gegenstand. Sie handelt nämlich nicht nur - wie Hunderte andere wissenschaftliche Theorien - von der "Welt da draußen“, sondern vor allem auch von uns selbst und von unserem Platz in dieser Welt. Den einen gilt sie obendrein als Überwinderin religiösen Aberglaubens, den anderen als neuer Zugang zu Gott und seinem Wirken in der Welt. Ferner sehen die einen in der Evolution eine unbezweifelbare Tatsache gleich der Schwerkraft oder dem Holocaust, die anderen aber eine - noch oder dauerhaft - unbewiesene Hypothese oder gar eine falsche Schöpfungslehre. Und während die meisten Streitfragen solcher Art nach wechselseitig akzeptierten Regeln ‚normaler Wissenschaft‘ geklärt werden, wird bei der Frage nach dem Woher unserer Spezies und Kultur die intellektuelle Zuständigkeit von Wissenschaft mitunter überhaupt bezweifelt. Anscheinend geht es schon um recht tiefe Schichten unserer Kultur und nicht nur der wissenschaftlichen, wenn - wie seit 150 Jahren - um die Evolutionstheorie gestritten wird. Wie sehen diese Schichten aus?

  1. The Ambiguous Dying Syndrome

    ERIC Educational Resources Information Center

    Bern-Klug, Mercedes

    2004-01-01

    More than one-half of the 2.4 million deaths that will occur in the United States in 2004 will be immediately preceded by a time in which the likelihood of dying can best be described as "ambiguous." Many people die without ever being considered "dying" or "at the end of life." These people may miss out on the…

  2. The Angry Dying Patient.

    PubMed

    Houston, Robert E.

    1999-02-01

    Over 25 years ago, Kubler-Ross identified anger as a predictable part of the dying process. When the dying patient becomes angry in the clinical setting, all types of communication become strained. Physicians can help the angry dying patient through this difficult time by using 10 rules of engagement. When physicians engage and empathize with these patients, they improve the patient's response to pain and they reduce patient suffering. When physicians educate patients on their normal responses to dying and enlist them in the process of family reconciliation, they can impact the end-of-life experience in a positive way.

  3. The Angry Dying Patient

    PubMed Central

    Houston, Robert E.

    1999-01-01

    Over 25 years ago, Kubler-Ross identified anger as a predictable part of the dying process. When the dying patient becomes angry in the clinical setting, all types of communication become strained. Physicians can help the angry dying patient through this difficult time by using 10 rules of engagement. When physicians engage and empathize with these patients, they improve the patient's response to pain and they reduce patient suffering. When physicians educate patients on their normal responses to dying and enlist them in the process of family reconciliation, they can impact the end-of-life experience in a positive way. PMID:15014699

  4. Energy Saving Melting and Revert Reduction Technology (E-SMARRT): Development of Surface Engineered Coating Systems for Aluminum Pressure Die Casting Dies: Towards a 'Smart' Die Coating

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dr. John J. Moore; Dr. Jianliang Lin,

    2012-07-31

    The main objective of this research program was to design and develop an optimal coating system that extends die life by minimizing premature die failure. In high-pressure aluminum die-casting, the die, core pins and inserts must withstand severe processing conditions. Many of the dies and tools in the industry are being coated to improve wear-resistance and decrease down-time for maintenance. However, thermal fatigue in metal itself can still be a major problem, especially since it often leads to catastrophic failure (i.e. die breakage) as opposed to a wear-based failure (parts begin to go out of tolerance). Tooling costs remain themore » largest portion of production costs for many of these parts, so the ability prevent catastrophic failures would be transformative for the manufacturing industry.The technology offers energy savings through reduced energy use in the die casting process from several factors, including increased life of the tools and dies, reuse of the dies and die components, reduction/elimination of lubricants, and reduced machine down time, and reduction of Al solder sticking on the die. The use of the optimized die coating system will also reduce environmental wastes and scrap parts. Current (2012) annual energy saving estimates, based on initial dissemination to the casting industry in 2010 and market penetration of 80% by 2020, is 3.1 trillion BTU's/year. The average annual estimate of CO2 reduction per year through 2020 is 0.63 Million Metric Tons of Carbon Equivalent (MM TCE).« less

  5. Neighbour-die effect on the measurement of wafer-level flip-chip LED dies in production lines

    NASA Astrophysics Data System (ADS)

    Chen, Tengfei; Wan, Zirui; Li, Bin

    2017-11-01

    The light from the side surfaces of the test flip-chip light-emitting diode (FCLED) dies is reflected, refracted or absorbed by neighbour dies during the measurement of wafer-level FCLED dies in production lines. A notable measurement deviation is caused by the neighbour-die effect, which is not considered in current industry practice. In this paper, Monte Carlo ray-tracing simulations are used to study the measurement deviations caused by the neighbour-die effect and extension ratios of the film. The simulation results show that the maximal deviation of radiant flux impinging the photodiode can reach 5.5%, if the die is tested without any neighbour dies, or is surrounded by a set of neighbour dies at an extension ratio of 1.1. Moreover, the dependence between the measurement results and neighbour cases for different extension ratios is also investigated. Then, a modified calibration method is proposed and studied. The proposed technique can be used to improve the calibration and measurement accuracy of the test equipment used for measurement of wafer-level FCLED dies in production lines.

  6. Extrusion die and method

    DOEpatents

    Lipp, G. Daniel

    1994-04-26

    A method and die apparatus for manufacturing a honeycomb body of rhombic cell cross-section by extrusion through an extrusion die of triangular cell discharge slot configuration, the die incorporating feedholes at selected slot intersections only, such that slot segments communicating directly with the feedholes discharge web material and slot segments not so connected do not discharge web material, whereby a rhombic cell cross-section in the extruded body is provided.

  7. Psychotherapy with Older Dying Persons.

    ERIC Educational Resources Information Center

    Dye, Carol J.

    Psychotherapy with older dying patients can lead to problems of countertransference for the clinician. Working with dying patients requires flexibility to adapt basic therapeutics to the institutional setting. Goals of psychotherapy must be reconceptualized for dying clients. The problems of countertransference arise because clinicians themselves…

  8. Pultrusion Die Assembly

    NASA Technical Reports Server (NTRS)

    Wilson, Maywood L. (Inventor); Johnson, Gary S. (Inventor); Frye, Mark W. (Inventor); Stanfield, Clarence E. (Inventor)

    1988-01-01

    This invention relates generally to pultrusion die assemblies, and more particularly, to a pultrusion die assembly which incorporates a plurality of functions in order to produce a continuous, thin composite fiber reinforced thermoplastic material. The invention is useful for making high performance thermoplastic composite materials in sheets which can be coiled on a spool and stored for further processing.

  9. Medizintechnik in der Tumororthopädie

    NASA Astrophysics Data System (ADS)

    Burgkart, Rainer; Gollwitzer, Hans; Holzapfel, Boris; Rudert, Maximilian; Rechl, Hans; Gradinger, Reiner

    Die Behandlung der Knochentumoren unterlag in den letzten 20 Jahren einem raschen und stetigen Wandel, was zum einen auf die verbesserten Therapieerfolge durch den Einsatz von neoadjuvanten Therapieformen zurückzuführen ist, und andererseits von medizintechnischen Entwicklungen bezüglich moderner Schnittbilddiagnostik, neuer 3D Operationsplanungsverfahren wie das Rapid Prototyping und adaptiv modularer Tumorendoprothesensystemen u. a. begleitet wurde. Gerade die technischen Entwicklungen haben dazu geführt, daß im Bereich der Extremitäten und der Wirbelsäule radikalere Eingriffe durchgeführt werden können, was die lokale Tumorkontrolle wesentlich verbessert hat. In zunehmenden Maße werden deshalb nicht nur Kurzzeiterfolge sondern auch mittel- und langfristige Fortschritte bei der Behandlung der malignen Knochentumoren einschließlich der Metastasenbehandlung erreicht. Grundlage der Therapie ist dabei immer primär die Sicherung der Diagnose mittels Biopsie und die bildgebende sowie histologische Stadieneinteilung des malignen Tumors. Nach der Tumorresektion kann die Rekonstruktion biologisch oder mit Endoprothesensystemen erfolgen. Gerade die weiterentwickelten modularen Systeme führen zu guten funktionellen Ergebnissen mit langen Standzeiten und einer reduzierten Komplikationsrate. Individuell angefertigte Implantate sind vor allem im Bereich der Rekonstruktion komplexer Beckentumoren von großer klinischer Bedeutung.

  10. Vacuum die attach for integrated circuits

    DOEpatents

    Schmitt, Edward H.; Tuckerman, David B.

    1991-01-01

    A thin film eutectic bond for attaching an integrated circuit die to a circuit substrate is formed by coating at least one bonding surface on the die and substrate with an alloying metal, assembling the die and substrate under compression loading, and heating the assembly to an alloying temperature in a vacuum. A very thin bond, 10 microns or less, which is substantially void free, is produced. These bonds have high reliability, good heat and electrical conduction, and high temperature tolerance. The bonds are formed in a vacuum chamber, using a positioning and loading fixture to compression load the die, and an IR lamp or other heat source. For bonding a silicon die to a silicon substrate, a gold silicon alloy bond is used. Multiple dies can be bonded simultaneously. No scrubbing is required.

  11. [Dying and death in societal transformation].

    PubMed

    Heller, Andreas; Wegleitner, Klaus

    2017-01-01

    Dying and death in modern societies are subject to profound social, professional and cultural-religious changes. Secularization and a stronger differentiation of societies have led to a change in the way humans handle the dying process. Normatively ritualized collective behaviour has been replaced by an individual, subjectivized approach. In late modern societies there are many different views of what "successful" or "good" dying means.In the article this change is described by the following seven theses: 1. We live longer and we die longer. 2. We no longer die suddenly and unexpectedly but slowly and foreseeably. 3. Even though our biological life on earth has become longer, our life has been shortened by the loss of eternity. 4. We no longer die on the stage of ritualized relationships with our family and neighbours but behind the curtains of organizations. 5. We live and die in a society of organizations and have to get organized for the final phase of our life. 6. Living and dying are no large, state-owned enterprises but small, private enterprises. 7. The hospice movement as well as palliative medicine have created public awareness, made dying a matter of discussion and offered a new set of options.In late modernism end-of-life care requires new approaches based on individual and shared responsibility as well as cooperation between professional institutions and community-based voluntary care.A change towards community care is visible. Thus "dying" is a topic in the discussion about the future of public health and societal solidarity.

  12. Apparatus for restraining and transporting dies

    DOEpatents

    Allison, James W.; LaBarre, Timothy L.

    1994-01-01

    Apparatus for restraining and transporting dies in punch press operations is provided. A floatation platen for supporting a die on the platen's upper surface has a plurality of recessed gas exhaust ports on the platen's lower surface. A source of pressurized gas delivers gas to a platen manifold, for delivery to orifices located in the gas exhaust ports. The flow of gas is controlled by a first valve adjacent the gas source and a second valve adjacent the manifold, with the second valve being used to control the gas flow during movement of the die. In this fashion, a die may be moved on a cushion of air from one workstation to a selected second workstation. A moveable hydraulically operated restraining fixture is also provided, for clamping the die in position during the compacting phase, and for releasing the die after completion of the compacting phase by releasing the hydraulic pressure on the restraining fixture. When pressure in the hydraulic cylinders on the restraining fixture is reversed, the restraining fixture will retract so that there is no contact between the die and the restraining fixture, thereby allowing the die to be removed from a first workstation and moved to a second selected workstation.

  13. Vacuum die attach for integrated circuits

    DOEpatents

    Schmitt, E.H.; Tuckerman, D.B.

    1991-09-10

    A thin film eutectic bond for attaching an integrated circuit die to a circuit substrate is formed by coating at least one bonding surface on the die and substrate with an alloying metal, assembling the die and substrate under compression loading, and heating the assembly to an alloying temperature in a vacuum. A very thin bond, 10 microns or less, which is substantially void free, is produced. These bonds have high reliability, good heat and electrical conduction, and high temperature tolerance. The bonds are formed in a vacuum chamber, using a positioning and loading fixture to compression load the die, and an IR lamp or other heat source. For bonding a silicon die to a silicon substrate, a gold silicon alloy bond is used. Multiple dies can be bonded simultaneously. No scrubbing is required. 1 figure.

  14. Reinraumtechnik für die Medizintechnik

    NASA Astrophysics Data System (ADS)

    Petek, Max; Jungbluth, Martin; Krampe, Erhard

    Die Reinraumtechnik ist heute ein unverzichtbarer Bestandteil bei der Fertigung von Produkten der Life Sciences, den Bereichen Pharma, Lebensmittel, Kosmetik und Medizintechnik. In Anbetracht der langen Historie der Medizintechnik ist sie jedoch eine sehr junge Disziplin. Die Bedeutung von Keimen und die richtige Einschätzung ihrer Größe wurden zwar sehr früh bereits durch Paracelsus erkannt, jedoch wurden daraus noch keine speziellen oder kontinuierlich umgesetzten Hygienevorschriften abgeleitet. Die erste bekannte technische Umsetzung von Hygieneempfehlungen geht auf den Franzosen François Nicolas Appert zurück, der eine aseptische Abfüllmethode für Lebensmittel entwickelte und diese 1810 veröffentlichte [1]. Die erste dokumentierte medizinische Umsetzung stellten Hygienevorschriften für Ärzte dar, die Ignaz Philipp Semmelweis nach 1847 in der Wiener Klinik für Geburtshilfe einführte [2].

  15. Contoured Orifice for Silicon-Ribbon Die

    NASA Technical Reports Server (NTRS)

    Mackintosh, B. H.

    1985-01-01

    Die configuration encourages purity and stable growth. Contour of die orifice changes near ribbon edges. As result, silicon ribbon has nearly constant width and little carbon contamination. Die part of furnace being developed to produce high-quality, low-cost material for solar cells.

  16. CAE Based Die Face Engineering Development to Contribute to the Revitalization of the Tool & Die Industry

    NASA Astrophysics Data System (ADS)

    Tang, Arthur; Lee, Wing C.; St. Pierre, Shawn; He, Jeanne; Liu, Kesu; Chen, Chin C.

    2005-08-01

    Over the past two decades, the Computer Aided Engineering (CAE) tools have emerged as one of the most important engineering tools in various industries, due to its flexibility and accuracy in prediction. Nowadays, CAE tools are widely used in the sheet metal forming industry to predict the forming feasibility of a wide variety of complex components, ranging from aerospace and automotive components to household products. As the demand of CAE based formability accelerates, the need for a robust and streamlined die face engineering tool becomes more crucial, especially in the early stage when the tooling layout is not available, but a product design decision must be made. Ability to generate blank, binder and addendum surfaces with an appropriate layout of Drawbead, Punch Opening Line, Trim Line are the primary features and functions of a CAE based die face engineering tool. Once the die face layout is ready, a formability study should be followed to verify the die face layout is adequate to produce a formable part. If successful, the established die face surface should be exported back to the CAD/CAM environment to speed up the tooling and manufacturing design process with confidence that this particular part is formable with this given die face. With a CAE tool as described above, the tool & die industry will be greatly impacted as the processes will enable the bypass of hardware try-out and shorten the overall vehicle production timing. The trend has shown that OEMs and first tiers will source to low cost producers in the world which will have a negative impact to the traditional tool & die makers in the developed countries. CAE based tool as described should be adopted, along with many other solutions, in order to maintain efficiency of producing high quality product and meeting time-to-market requirements. This paper will describe how a CAE based die face engineering (DFE) tool could be further developed to enable the traditional tool & die makers to meet the

  17. Navigating "Assisted Dying".

    PubMed

    Schipper, Harvey

    2016-02-01

    Carter is a bellwether decision, an adjudication on a narrow point of law whose implications are vast across society, and whose impact may not be realized for years. Coupled with Quebec's Act Respecting End-of-life Care it has sharply changed the legal landscape with respect to actively ending a person's life. "Medically assisted dying" will be permitted under circumstances, and through processes, which have yet to be operationally defined. This decision carries with it moral assumptions, which mean that it will be difficult to reach a unifying consensus. For some, the decision and Act reflect a modern acknowledgement of individual autonomy. For others, allowing such acts is morally unspeakable. Having opened the Pandora's Box, the question becomes one of navigating a tolerable societal path. I believe it is possible to achieve a workable solution based on the core principle that "medically assisted dying" should be a very rarely employed last option, subject to transparent ongoing review, specifically as to why it was deemed necessary. My analysis is based on 1. The societal conditions in which have fostered demand for "assisted dying", 2. Actions in other jurisdictions, 3. Carter and Quebec Bill 52, 4. Political considerations, 5. Current medical practice. Leading to a series of recommendations regarding. 1. Legislation and regulation, 2. The role of professional regulatory agencies, 3. Medical professions education and practice, 4. Public education, 5. Health care delivery and palliative care. Given the burden of public opinion, and the legal steps already taken, a process for assisted-dying is required. However, those legal and regulatory steps should only be considered a necessary and defensive first step in a two stage process. The larger goal, the second step, is to drive the improvement of care, and thus minimize assisted-dying.

  18. L-connect routing of die surface pads to the die edge for stacking in a 3D array

    DOEpatents

    Petersen, Robert W.

    2000-01-01

    Integrated circuit chips and method of routing the interface pads from the face of the chip or die to one or more sidewall surfaces of the die. The interconnection is routed from the face of the die to one or more edges of the die, then routed over the edge of the die and onto the side surface. A new pad is then formed on the sidewall surface, which allows multiple die or chips to be stacked in a three-dimensional array, while enabling follow-on signal routing from the sidewall pads. The routing of the interconnects and formation of the sidewall pads can be carried out in an L-connect or L-shaped routing configuration, using a metalization process such as laser pantography.

  19. Extrusion die and method

    DOEpatents

    Lipp, G. Daniel

    1994-05-03

    A method and die apparatus for manufacturing a honeycomb body of triangular cell cross-section and high cell density, the die having a combination of (i) feedholes feeding slot intersections and (ii) feedholes feeding slot segments not supplied from slot intersections, whereby a reduction in feedhole count is achieved while still retaining good extrusion efficiency and extrudate uniformity.

  20. Differentiating suicide decedents who died using firearms from those who died using other methods.

    PubMed

    Anestis, Michael D; Khazem, Lauren R; Anestis, Joye C

    2017-06-01

    Studies have documented a link between gun ownership and suicide, but little is known about characteristics of those most likely to use a gun in a suicide attempt rather than alternative methods. We examined which factors differentiate suicide decedents who died using a gun from those who died by other methods. We further examined whether such findings are consistent within the subcomponent of our larger sample comprised entirely of gun owning suicide decedents. Data reflect 267 suicide decedents, with data provided by individuals who identified as having lost someone to suicide (loss survivors). Within the full sample, a higher proportion of gun-owning and male suicide decedents died by firearm. Further, individuals who had previously discussed suicide or engaged in one or more non-lethal suicide attempts were less likely to die by suicide using a gun. Within the subsample of gun owning suicide decedents, a greater proportion of decedents who stored guns at home and in unsecure locations died from self-inflected gunshot wounds. These findings add clarity to the relationship between firearm ownership and death by suicide at the individual level. Furthermore, these findings are consistent with the notion that means safety implementation may represent a vital suicide prevention tool. Copyright © 2017. Published by Elsevier B.V.

  1. Energy Consumption of Die Casting Operations

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jerald Brevick; clark Mount-Campbell; Carroll Mobley

    2004-03-15

    Molten metal processing is inherently energy intensive and roughly 25% of the cost of die-cast products can be traced to some form of energy consumption [1]. The obvious major energy requirements are for melting and holding molten alloy in preparation for casting. The proper selection and maintenance of melting and holding equipment are clearly important factors in minimizing energy consumption in die-casting operations [2]. In addition to energy consumption, furnace selection also influences metal loss due to oxidation, metal quality, and maintenance requirements. Other important factors influencing energy consumption in a die-casting facility include geographic location, alloy(s) cast, starting formmore » of alloy (solid or liquid), overall process flow, casting yield, scrap rate, cycle times, number of shifts per day, days of operation per month, type and size of die-casting form of alloy (solid or liquid), overall process flow, casting yield, scrap rate, cycle times, number of shifts per day, days of operation per month, type and size of die-casting machine, related equipment (robots, trim presses), and downstream processing (machining, plating, assembly, etc.). Each of these factors also may influence the casting quality and productivity of a die-casting enterprise. In a die-casting enterprise, decisions regarding these issues are made frequently and are based on a large number of factors. Therefore, it is not surprising that energy consumption can vary significantly from one die-casting enterprise to the next, and within a single enterprise as function of time.« less

  2. Declarations on euthanasia and assisted dying.

    PubMed

    Inbadas, Hamilton; Zaman, Shahaduz; Whitelaw, Sandy; Clark, David

    2017-10-01

    Declarations on end-of-life issues are advocacy interventions that seek to influence policy, raise awareness and call others to action. Despite increasing prominence, they have attracted little attention from researchers. This study tracks the emergence, content, and purpose of declarations concerned with assisted dying and euthanasia, in the global context. The authors identified 62 assisted dying/euthanasia declarations covering 1974-2016 and analyzed them for originating organization, geographic scope, format, and stated viewpoint on assisted dying/euthanasia. The declarations emerged from diverse organizational settings and became more frequent over time. Most opposed assisted dying/euthanasia.

  3. Declarations on euthanasia and assisted dying

    PubMed Central

    Inbadas, Hamilton; Zaman, Shahaduz; Whitelaw, Sandy; Clark, David

    2017-01-01

    ABSTRACT Declarations on end-of-life issues are advocacy interventions that seek to influence policy, raise awareness and call others to action. Despite increasing prominence, they have attracted little attention from researchers. This study tracks the emergence, content, and purpose of declarations concerned with assisted dying and euthanasia, in the global context. The authors identified 62 assisted dying/euthanasia declarations covering 1974–2016 and analyzed them for originating organization, geographic scope, format, and stated viewpoint on assisted dying/euthanasia. The declarations emerged from diverse organizational settings and became more frequent over time. Most opposed assisted dying/euthanasia. PMID:28398131

  4. Recognizing dying in terminal illness.

    PubMed

    Taylor, Paul M; Johnson, Miriam

    2011-08-01

    Recognizing dying in terminally ill patients is a complex clinical skill. This article outlines the approach to the decision, common difficulties encountered in patients with both malignant and non-malignant disease, and a simple approach to considering the question 'Is this patient dying?'

  5. Die singulation method and package formed thereby

    DOEpatents

    Anderson, Robert C [Tucson, AZ; Shul, Randy J [Albuquerque, NM; Clews, Peggy J [Tijeras, NM; Baker, Michael S [Albuquerque, NM; De Boer, Maarten P [Albuquerque, NM

    2012-08-07

    A method is disclosed for singulating die from a substrate having a sacrificial layer and one or more device layers, with a retainer being formed in the device layer(s) and anchored to the substrate. Deep Reactive Ion Etching (DRIE) etching of a trench through the substrate from the bottom side defines a shape for each die. A handle wafer is then attached to the bottom side of the substrate, and the sacrificial layer is etched to singulate the die and to form a frame from the retainer and the substrate. The frame and handle wafer, which retain the singulated die in place, can be attached together with a clamp or a clip and to form a package for the singulated die. One or more stops can be formed from the device layer(s) to limit a sliding motion of the singulated die.

  6. Dying: A universal human experience?

    PubMed

    Bregman, L

    1989-03-01

    This paper explores the question, "Is there a universal psychological experience suffered by all dying persons?" a question to which the popular theory of Kübler-Ross presupposes an affirmative answer. Our answer takes three steps: first, a comparison between the Kübler-Ross model of dying and that of the late medievalBook of the Craft of Dying centered upon the five Kübler-Ross "stages"; second, a philosophical critique of the terms of this comparison; and third, a revised look at the alleged similarities between the two models, providing a deeper look at the moral and spiritual assumptions behind each.

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

    PubMed

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

    2015-08-01

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

  8. Bereits nach Ablauf der Halbwertszeit droht der vollständige Zerfall Die britische Atomic Scientists’ Association, die Ideologie der „objektiven” Wissenschaft und die H-Bombe

    NASA Astrophysics Data System (ADS)

    Laucht, Christoph

    Präsident Harry Trumans Verlautbarung vom 31.1.1950, seine Regierung wolle die Entwicklung der Wasserstoffbombe vorantreiben, fand große Beachtung in den britischen Medien. Die illustrierte Zeitschrift Picture Post widmete der HBombe einen Artikel, der unter anderem kurze Stellungnahmen der britischen Atomwissenschaftler Eric Burhop, Kathleen Lonsdale, Harrie Massey, Rudolf Peierls und Maurice Pryce enthielt, die alle Mitglieder der Atomic Scientists' Association (ASA) waren.

  9. Die Deformation Measurement System during Sheet Metal Forming

    NASA Astrophysics Data System (ADS)

    Funada, J.; Takahashi, S.; Fukiharu, H.

    2011-08-01

    In order to reduce affection to the earth environment, it is necessary to lighten the vehicles. For this purpose, high tensile steels are applied. Because of high strength, high forming force is required for producing automotive sheet metal parts. In this situation, since the dies are elastic, they are deformed during forming parts. For reducing die developing period, sheet metal forming simulation is widely applied. In the numerical simulation, rigid dies are usually used for shortening computing time. It means that the forming conditions in the actual forming and the simulation are different. It will make large errors in the results between actual forming and simulation. It can be said that if contact pressure between dies and a sheet metal in the simulation can be reproduced in the actual forming, the differences of forming results between them can also been reduced. The basic idea is to estimate die shape which can produce the same distribution as computed from simulation with rigid dies. In this study, die deformation analyses with Finite Element Method as basic technologies are evaluated. For example, simple shape and actual dies elastic contact problems were investigated. The contact width between simple shape dies was investigated. The computed solutions were in good agreement with experimental results. The one case of the actual dies in two cases was also investigated. Bending force was applied to the blank holder with a mechanical press machine. The methodology shown with applying inductive displacement sensor for measuring die deformation during applying force was also proposed.

  10. Einführung in die Technische Chemie

    NASA Astrophysics Data System (ADS)

    Behr, Arno; Agar, David W.; Jörissen, Jakob

    Die "Technische Chemie" ist ein Lehrfach an Universitäten und Hochschulen. Nach dem die Studierenden der Chemie in den ersten Semestern ihres Studiums ausrei chen de theoretische Kenntnisse in Allgemeiner, Anorganischer, Organischer und Physikalischer Chemie erlangt haben, soll die Technische Chemie einen Blick auf die praktische Anwendung dieser Naturwissenschaft in unserer Wirtschaft lenken. Es gibt keine "biologische Industrie", "physikalische Industrie" oder "mathematische Industrie", wohl aber seit über 150 Jahren eine "chemische Industrie", die in dieser lan gen Zeit zahlreiche chemische Prozesse entwickelt und dazu vielfältige Methoden erarbeitet hat. Das Lehrfach Technische Chemie gibt einen Überblick über diese Pro zesse und Methoden und erleichtert dadurch den Schritt von der Universität zur be ruflichen Praxis.

  11. 25 CFR 301.4 - Application of dies.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Application of dies. 301.4 Section 301.4 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER AND TURQUOISE PRODUCTS; STANDARDS § 301.4 Application of dies. Dies are to be applied to the object with the aid of...

  12. Nursing students' experiences caring for dying patients.

    PubMed

    Beck, C T

    1997-11-01

    Since the 1960s nurse educators have been searching for the most effective approach to prepare nursing students for care of the dying. Studies investigating the effectiveness of death education programs for nursing students have reported inconsistent findings. A phenomenological study was conducted to explore the meaning of 26 undergraduate nursing students' experiences in caring for dying patients. The nursing students' written descriptions of their experiences were analyzed using Colaizzi's (1978) phenomenological method. Six themes emerged from this analysis. While caring for dying patients, nursing students experienced a gamut of emotions such as fear, sadness, frustration, and anxiety. Contemplation of the patient's life and death occurred as the students cared for their patients. In addition to providing physical, emotional, and spiritual support for dying patients, an integral part of nursing students' care involved supporting the patients' families. Helplessness was experienced by the students regarding their role as patient advocates. While caring for dying patients, nursing students' learning fluorished. Educational strategies for preparing nursing students to care for the dying are addressed based on the findings of this qualitative study.

  13. Der Einfluss der Digitalisierung auf die Organisation eines Unternehmens

    NASA Astrophysics Data System (ADS)

    Walter, Wolfram M.

    Die Digitalisierung schreitet mit großen Schritten voran. Dies wirkt sich nicht nur auf die Gesellschaft im Grundsatz, sondern auch auf das Verhalten der Kunden aus. Neue Kommunikationswege beschleunigen die Interaktion zwischen Unternehmen und Verbraucher. Im Vergleich mit großen Internetfirmen werden etablierte Dienstleistungsunternehmen - vom Energieversorger bis zu Versicherungen - stark unter Druck gesetzt, sich noch intensiver mit dem Kundenservice auseinanderzusetzen. Dies wird nur möglich sein, wenn sich die Organisationen entsprechend positionieren und sich frühzeitig auf die Veränderungen einstellen. Hieraus ergeben sich mehr Chancen als Risiken, zumal es nicht nur neue Prozesse, sondern auch neue Berufsbilder geben wird.

  14. Numerical simulation and experiment on multilayer stagger-split die.

    PubMed

    Liu, Zhiwei; Li, Mingzhe; Han, Qigang; Yang, Yunfei; Wang, Bolong; Sui, Zhou

    2013-05-01

    A novel ultra-high pressure device, multilayer stagger-split die, has been constructed based on the principle of "dividing dies before cracking." Multilayer stagger-split die includes an encircling ring and multilayer assemblages, and the mating surfaces of the multilayer assemblages are mutually staggered between adjacent layers. In this paper, we investigated the stressing features of this structure through finite element techniques, and the results were compared with those of the belt type die and single split die. The contrast experiments were also carried out to test the bearing pressure performance of multilayer stagger-split die. It is concluded that the stress distributions are reasonable and the materials are utilized effectively for multilayer stagger-split die. And experiments indicate that the multilayer stagger-split die can bear the greatest pressure.

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

    PubMed

    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.

  16. Sheet metal stamping die design for warm forming

    DOEpatents

    Ghosh, Amit K.

    2003-04-22

    In metal stamping dies, by taking advantage of improved material flow by selectively warming the die, flat sections of the die can contribute to the flow of material throughout the workpiece. Local surface heating can be accomplished by placing a heating block in the die. Distribution of heating at the flat lower train central regions outside of the bend region allows a softer flow at a lower stress to enable material flow into the thinner, higher strain areas at the bend/s. The heating block is inserted into the die and is powered by a power supply.

  17. Fast lichtschnell durch die Stadt: Visualisierung relativistischer Effekte

    NASA Astrophysics Data System (ADS)

    Kraus, Ute; Borchers, Marc P.

    2005-03-01

    Eine Computersimulation ermöglicht es uns, mit annähernd Lichtgeschwindigkeit durch die Tübinger Fußgängerzone zu fahren. Was wir dabei sehen, ist verblüffend: Die Häuser vor uns rücken umso weiter in die Ferne, je mehr wir beschleunigen; gleichzeitig erscheinen die Hauskanten in unserer Nähe immer stärker gekrümmt. Der Grund für diese merkwürdigen Bilder ist die so genannte Aberration: Ein und derselbe Lichtstrahl hat für den fahrenden Beobachter eine andere Richtung als für denjenigen, der am Straßenrand steht. Dieser Effekt ist im Alltag klein. Wenn wir aber in der Simulation fast lichtschnell durch die Tübinger Altstadt rasen, ist er dramatisch groß.

  18. Assisted Dying in Canada.

    PubMed

    Schuklenk, Udo

    This paper makes an affirmative ethical case in favour of the decriminalization of assisted dying in Canada. It then proceeds to defending the affirmative case against various slippery-slope arguments that are typically deployed by opponents of assisted dying. Finally, a recent case of questionable professional conduct by anti-euthanasia campaigners cum academics is flagged as a warning to all of us not to permit the quality of the professional debate to deteriorate unacceptably, despite the personal emotional investments involved on all sides of the debate.

  19. A clinical perspective on dying

    PubMed Central

    Janes, Robert G.

    1972-01-01

    There is continuing need for dissemination of already available, clinically useful knowledge concerning the psychological needs of the seriously ill and dying. Against the changing social context of dying, some of our erroneous assumptions about these patients are explored and the genuine fears and personal needs are discussed. The implications of this knowledge for medical education are recognized. PMID:5074753

  20. Historical review of die drool phenomenon during plastics extrusion

    NASA Astrophysics Data System (ADS)

    Musil, Jan; Zatloukal, Martin

    2013-04-01

    Die drool phenomenon is defined as unwanted spontaneous accumulation of extruded polymer melt on open faces of extrusion die during extrusion process. Such accumulated material builds up on the die exit and frequently or continually sticks onto the extruded product and thus damages it. Since die drool appears, extrusion process must be shut down and die exit must be manually cleaned which is time and money consuming. Although die drool is complex phenomenon and its formation mechanism is not fully understood yet, variety of proposed explanations of its formation mechanism and also many ways to its elimination can be found in open literature. Our review presents in historical order breakthrough works in the field of die drool research, shows many ways to suppress it, introduces methods for its quantitative evaluation and composition analysis and summarizes theories of die drool formation mechanism which can be helpful for extrusion experts.

  1. The Dying Role: Its Relevance to Improved Patient Care.

    PubMed

    Noyes, Russell; Clancy, John

    2016-01-01

    SOCIETY is failing to meet the obligation it has to its dying members. Persons with terminal illnesses suffer isolation and neglect in hospitals, receive overzealous treatment by physicians, and are kept in ignorance of their situation by families and medical personnel. Evidence for these statements has come from observers of the medical care system and from dying patients themselves (Kübler-Ross, 1969; Reynolds and Kalish, 1974; Sudnow, 1967). In the nineteenth century it was common for persons to die in the familiar environs of their homes, surrounded by grieving families from whom they parted in a meaningful manner (Blauner, 1966). Dying persons of today no longer fill a well-defined social role. Instead, the distinction between the roles of sick and dying persons has been lost and, in the resulting confusion, the care of dying people has suffered. The purpose of this article is to clarify the distinction between the dying and sick roles, identify the signs of existing role confusion, suggest ways in which this confusion may be corrected, and show how reestablishment of the dying role can result in improved care of dying people. The important part physicians play in defining sick and dying roles will be emphasized.

  2. 'Bridging worlds': meeting the emotional needs of dying patients.

    PubMed

    Law, Rollanda

    2009-12-01

    This paper is a report of a study to develop a grounded theory to explain how district nurses meet the emotional needs of dying patients in the community. There has been a policy commitment internationally to improve community services and enable people with terminal illnesses to die in their own homes. This increasing trend towards home deaths in the United Kingdom (UK) makes more demand on district nurses to provide emotional support for dying patients. A 'classic' grounded theory study was conducted in the UK between 2002 and 2005. Unstructured observations and semi-structured interviews were conducted with a purposive sample of nine district nurses, nine patients and four family carers. A further theoretical sample of five books of authors' accounts of their dying experiences and three district nurses who were advanced practitioners were selected. Five categories were identified in the data: 'outside world', 'dying world', 'entering dying world', 'maintaining connections' and the core category 'bridging worlds'. The theory of 'bridging worlds' indicated that dying patients experienced 'dying world' and 'outside world'. District nurses met dying patients' emotional needs by acting as a bridge between their two worlds, encouraging them to maintain connections with the outside world so that they did not become isolated in their dying world. District nurses should ensure that they meet both the physical and emotional needs of dying patients. Nursing education and literature need to concentrate on raising awareness of nurses' role in providing emotional support.

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

    PubMed Central

    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

  4. Acting to let someone die.

    PubMed

    McGee, Andrew

    2015-02-01

    This paper examines the recent prominent view in medical ethics that withdrawing life-sustaining treatment (LST) is an act of killing. I trace this view to the rejection of the traditional claim that withdrawing LST is an omission rather than an act. Although that traditional claim is not as problematic as this recent prominent view suggests, my main claim is that even if we accepted that withdrawing LST should be classified as an act rather than as an omission, it could still be classified as letting die rather than killing. Even though omissions are contrasted with acts, letting die need not be, for one can let die by means of acts. The remainder of the paper is devoted to establishing this claim and addresses certain objections to it. © 2013 John Wiley & Sons Ltd.

  5. Computer aided system for parametric design of combination die

    NASA Astrophysics Data System (ADS)

    Naranje, Vishal G.; Hussein, H. M. A.; Kumar, S.

    2017-09-01

    In this paper, a computer aided system for parametric design of combination dies is presented. The system is developed using knowledge based system technique of artificial intelligence. The system is capable to design combination dies for production of sheet metal parts having punching and cupping operations. The system is coded in Visual Basic and interfaced with AutoCAD software. The low cost of the proposed system will help die designers of small and medium scale sheet metal industries for design of combination dies for similar type of products. The proposed system is capable to reduce design time and efforts of die designers for design of combination dies.

  6. REFRACTORY DIE FOR EXTRUDING URANIUM

    DOEpatents

    Creutz, E.C.

    1959-08-11

    A die is presented for the extrusion of metals, said die being formed of a refractory complex oxide having the composition M/sub n/O/sub m/R/sub x/O/sub y/ where M is magnesium, zinc, manganese, or iron, R is aluminum, chromic chromium, ferric iron, or manganic manganese, and m, n, x, and y are whole numbers. Specific examples are spinel, magnesium aluminate, magnetite, magnesioferrite, chromite, and franklinite.

  7. A Contingency Framework for Listening to the Dying

    ERIC Educational Resources Information Center

    Vora, Erika; Vora, Ariana

    2008-01-01

    Listening to the dying poses special challenges. This paper proposes a contingency framework for describing and assessing various circumstances when listening to the dying. It identifies current approaches to listening, applies the contingency framework toward effectively listening to the dying, and proposes a new type of listening called…

  8. Die nuklearen Anlagen von Hanford (1943-1987) Eine Fallstudie über die Schnittstellen von Physik, Biologie und die US-amerikanische Gesellschaft zur Zeit des Kalten Krieges

    NASA Astrophysics Data System (ADS)

    Macuglia, Daniele

    Die Geschichte des Kalten Krieges eröffnet viele Möglichkeiten, sich näher mit den Schnittstellen von Physik und Biologie während des 20. Jahrhunderts zu befassen. Nicht nur das Unglück in Tschernobyl aus dem Jahr 1986, auch das Beispiel der nuklearen Anlagen in Hanford in den Vereinigten Staaten zeigt die biologischen Folgen von nuklearer Physik.

  9. Regional ontogeny of New England salt marsh die-off.

    PubMed

    Coverdale, Tyler C; Bertness, Mark D; Altieri, Andrew H

    2013-10-01

    Coastal areas are among the world's most productive and highly affected ecosystems. Centuries of human activity on coastlines have led to overexploitation of marine predators, which in turn has led to cascading ecosystem-level effects. Human effects and approaches to mediating them, however, differ regionally due to gradients in biotic and abiotic factors. Salt marsh die-off on Cape Cod, Massachusetts (U.S.A.), triggered by a recreational-fishing-induced trophic cascade that has released herbivorous crabs from predator control, has been ongoing since 1976. Similar salt marsh die-offs have been reported in Long Island Sound and Narragansett Bay (U.S.A.), but the driving mechanism of these die-offs has not been examined. We used field experiments to assess trophic interactions and historical reconstructions of 24 New England marshes to test the hypotheses that recreational fishing and predator depletion are a regional trigger of salt marsh die-off in New England and that die-offs in Long Island Sound and Narragansett Bay are more recent than those on Cape Cod. Predator depletion was the general trigger of marsh die-off and explained differences in herbivorous crab abundance and the severity of die-off across regions. Die-offs in Long Island Sound and Narragansett Bay are following a trajectory similar to die-off on Cape Cod, but are approximately 20 years behind those on Cape Cod. As a result, die-off currently affects 31.2% (SE 2.2) of low-marsh areas in Long Island Sound and Narragansett Bay, less than half the severity of die-off on Cape Cod. Our results contribute to the growing evidence that recreational fishing is an increasing threat to coastal ecosystems and that studying the effects of human activity at regional scales can provide insight into local effects and aid in early detection and potential remediation. © 2013 Society for Conservation Biology.

  10. 25 CFR 304.5 - Dies to identify tribe.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 2 2014-04-01 2014-04-01 false Dies to identify tribe. 304.5 Section 304.5 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER, USE OF GOVERNMENT MARK § 304.5 Dies to identify tribe. Dies are marked with name of tribe. A Navajo stamp will be...

  11. 25 CFR 304.5 - Dies to identify tribe.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 2 2011-04-01 2011-04-01 false Dies to identify tribe. 304.5 Section 304.5 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER, USE OF GOVERNMENT MARK § 304.5 Dies to identify tribe. Dies are marked with name of tribe. A Navajo stamp will be...

  12. 25 CFR 304.5 - Dies to identify tribe.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 2 2012-04-01 2012-04-01 false Dies to identify tribe. 304.5 Section 304.5 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER, USE OF GOVERNMENT MARK § 304.5 Dies to identify tribe. Dies are marked with name of tribe. A Navajo stamp will be...

  13. 25 CFR 304.5 - Dies to identify tribe.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 2 2013-04-01 2013-04-01 false Dies to identify tribe. 304.5 Section 304.5 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER, USE OF GOVERNMENT MARK § 304.5 Dies to identify tribe. Dies are marked with name of tribe. A Navajo stamp will be...

  14. Assisted dying - should the UK change its stance?

    PubMed

    Gordon, Daniel; Raphael, Claire E; Vassiliou, Vassilios

    2015-04-01

    Along with an increasing interest in assisted dying by many European and North American countries, some of which have already modified their existing laws to accommodate this, the interest in assisted dying in the UK has increased once again following Lord Falconer's Assisted Dying for the Terminally Ill Bill. Drawing on examples from countries where similar assisted dying laws are already in place, this article analyses and contextualises the proposed bill and discusses its potential pitfalls and benefits for the UK. © The European Society of Cardiology 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  15. Meditations on the unitary rhythm of dying-grieving.

    PubMed

    Malinski, Violet M

    2012-07-01

    When someone faces loss of a loved one, that person simultaneously grieves and dies a little, just as the one dying also grieves. The author's personal conceptualization of dying and grieving as a unitary rhythm is explored based primarily on her interpretation of Rogers' science of unitary human beings, along with selected examples from related nursing literature and from the emerging focus on continuing bonds in other disciplines. Examples from contemporary songwriters that depict such a unitary conceptualization are given along with personal examples. The author concludes with her description of the unitary rhythm of dying-grieving.

  16. Will the UK Supreme Court allow assisted dying?

    PubMed

    Griffith, Richard

    MPs overwhelmingly voted against passing the Assisted Dying Bill into law in September 2015. The Bill was defeated by a majority of 212, despite the heartfelt pleas of many MPs to pass it into law. The size of the defeat means that it is unlikely that Parliament will consider a similar law for many years. Yet many considered the Bill their last opportunity to make assisted dying lawful. There is, however, one further possible way assisted dying could become lawful in the UK--and that would be where the Supreme Court allowed it. In this article, the author reviews the Supreme Court's decision in R (on the application of Nicklinson v Ministry of Justice [2014] and considers how likely it is that the Supreme Court will now sanction assisted dying following Parliament's refusal to enact an assisted dying law.

  17. Portable punch and die jig

    DOEpatents

    Lewandowski, Edward F.; Anderson, Petrus A.

    1978-01-01

    A portable punch and die jig includes a U-shaped jig of predetermined width having a slot of predetermined width in the base thereof extending completely across the width of the jig adapted to fit over the walls of rectangular tubes and a punch and die assembly disposed in a hole extending through the base of the jig communicating with the slot in the base of the jig for punching a hole in the walls of the rectangular tubes at precisely determined locations.

  18. Improvement of Die Corner Filling in Box-shape Stepped Tubes Hydroforming

    NASA Astrophysics Data System (ADS)

    Hosseini-Farrash, S. H.; Elyasi, M.; Bakhshi-Jooybari, M.; Gorji, A.

    2011-01-01

    A new die design to improve the die corner filling in the hydroforming of square-sectional stepped tubes is presented. The proposed die-set contains two additional bushes, compared to the common tube hydroforming dies. First, the tube is placed into the die, filled with liquid, and sealed with the punches. Then, by increasing the internal pressure, the tube is bulged and contacts the die walls (bulging stage). By maintaining the internal pressure, the two upper and lower bushes move until the die cavity is filled completely (calibration stage). The proposed die was simulated and the results show that sharp corners of the part and relatively complete filling of the die cavity can be obtained by using this die set. In order to verify the results, some experiments have been carried out. The experimental results verified the results obtained from the simulations. The thickness distribution of the part is also investigated and it is shown that fairly uniform thickness distribution can be obtained by using the proposed die set.

  19. Optimization of Composition and Heat Treating of Die Steels for Extended Lifetime

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    David Schwam; John F. Wallace; Quanyou Zhou

    2002-01-30

    An ''average'' die casting die costs fifty thousand dollars. A die used in making die cast aluminum engine blocks can cost well over one million dollars. These costs provide a strong incentive for extension of die life. While vacuum quenched Premium Grade H13 dies have become the most widely used in the United States, tool makers and die casters are constantly searching for new steels and heat treating procedures to extend die life. This project was undertaken to investigate the effects of composition and heat treating on die life and optimize these parameters.

  20. Dying in the age of choice.

    PubMed

    Black, Kathy; Csikai, Ellen L

    2015-01-01

    Due to the unprecedented increase in the United States aging demographics, many more people are living longer and reaching older ages than ever before. However, a longer life is not necessarily a better life, as the vast majority will face a period of prolonged deteriorating health prior to death. Although notable efforts have been underway that are designed to improve the end-of-life experience, increasing numbers of individuals express a desire and/or act upon an intent to end their lives precipitously. Though still limited, the options to actively participate in their own deaths are growing. Requests for a hastened death can occur among people of all ages and includes those with advanced illness as well as others wanting to die due to unbearable suffering. This article provides an overview of the ongoing discourse about the experience of dying faced by many older adults, including aspects frequently associated with "a good death." The limitations of established practices which seek to provide a "better" dying experience are identified followed by discussion of the growing availability of alternative options. Reflective considerations are presented to guide practice vis-à-vis the changing landscape surrounding options in dying.

  1. Darwin als Sehhilfe für die Psychologie - Evolutionspsychologie

    NASA Astrophysics Data System (ADS)

    Schwab, Frank

    Im Folgenden geht es um Einäugige, stereoskopisches Sehen, weite und enge Horizonte, Monokel und Sonnenbrillen. Der Beitrag versucht die Metapher des Sehens und der Sehhilfen anzuwenden, um so zu verdeutlichen, welchen Gewinn die herkömmliche Psychologie durch die Verwendung einer Darwin'schen Brille erlangen kann.

  2. Low Temperature Consolidation of Micro/Nanosilver Die-Attach Preforms

    NASA Astrophysics Data System (ADS)

    McCoppin, Jared; Reitz, Thomas L.; Miller, Ryan; Vijwani, Hema; Mukhopadhyay, Sharmila; Young, Daniel

    2014-09-01

    Organically passivated silver nanopowder paste-based sintering is considered a promising solution for die-attach in high temperature power and sensing electronic devices. However, oxygen requirements during burnout and inherently high shrinkage rates limit their use to small die sizes. This work reports an alternative fabrication method that resolves decomposition and shrinkage issues of the die-attach by utilizing a prestressed optimized tape cast mixture of micro- and nanosilver particles with a polypropylene carbonate binder. The effects of prestressing, micro/nanosilver bimodal distribution, and polymer content on resulting microstructure and shear strength were investigated. Prior to application as a die-attach, uniaxial compression of the tape was found to significantly decrease shrinkage and improve green strength. This pre-stressing strategy allows for a decoupling of the resulting die-attach materials properties from the pressure applied during assembly. Bimodal mixtures consisting of 1-3 μm spherical powders with nanosilver resulted in shear strengths comparable to those of pure nanosilver. Shear strength decreased as bimodal particle size increased above 5 μm. A polymer content of ˜10 wt.% polypropylene carbonate combined with prestressing was identified as optimal for maximizing die-attach shear strength while still maintaining pliability and formability. Tape casts that were prestressed to 212 MPa by uniaxially compression and formulated with 10 wt.% of polypropylene carbonate resulted in a die-attach material with a shear strength of 54 MPa when sintered. These materials were used to demonstrate void-free 25-mm2 die-attach assemblies, suggesting that tape cast micro/nanosilver materials may be a promising die-attach method for high temperature and large-area electronics devices.

  3. Digitalisierung und Energie 4.0 - Wie schaffen wir die digitale Energiewende?

    NASA Astrophysics Data System (ADS)

    Irlbeck, Maximilian

    Die digitale Energiewende verändert nachhaltig die Systeme der "alten" Energiewelt. Ein Zusammenwachsen verschiedener Domänen im Energiesystem, die durch digitale Technologie möglich wird, birgt enorme Herausforderungen, ist aber notwendig, um die Energiewende und ihre Ziele zu meistern. Dieser Beitrag beschreibt die Wirkung der Digitalisierung auf das Energiesystem, listet Charakteristika der digitalen Energiewende auf und schildert für verschiedene Domänen mögliche Zielvorstellungen, die durch digitale Technologie umsetzbar sind. Am Ende erläutert der Beitrag Handlungsschritte, die auf dem Weg zu einem erneuerbaren Energiesystem gegangen werden sollten und zeigt Probleme und Risiken einer Fehlentwicklung auf.

  4. Killing, letting die and euthanasia.

    PubMed Central

    Husak, D N

    1979-01-01

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

  5. Killing, letting die and euthanasia.

    PubMed

    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.

  6. Death and Dying: Issues for Educational Gerontologists.

    ERIC Educational Resources Information Center

    Wass, Hannelore, Myers, Jane E.

    1984-01-01

    Reviews research on death orientations, the dying process, and bereavement, with a major focus on the elderly. Suggests that relevant knowledge about death and dying are important for gerontological practitioners and proposes that death-related content be systematically integrated into academic curricula at the preservice and inservice levels.…

  7. Kundenfokus: Startpunkt für die digitale Transformation bei Stadtwerken

    NASA Astrophysics Data System (ADS)

    Fett, Perry; Küller, Philipp

    Big Data, Internet der Dinge, Mobile Computing und soziale Medien - die modernen Informationstechnologien durchdringen den Alltag der meisten Menschen und lösen hierdurch eine digitale Transformation aus. Im Unternehmenskontext manifestiert sich die Digitalisierung durch eine neue Qualität der wissensbasierten Entscheidungsunterstützung und der Automatisierung bzw. Autonomisierung der Geschäftsprozesse. Für Stadtwerke gilt es nun, die Chancen der Digitalisierung zu ihren Gunsten zu nutzen. Ein Startpunkt könnte hierbei sein, wie Stadtwerke zukünftig mit ihren Kunden interagieren. Ausgelöst durch die Liberalisierung der Märkte rückt der Kunde heute stärker in den Mittelpunkt - die Energiewirtschaft steht nun vor der Herausforderung, dem Wettbewerb einen Schritt voraus zu sein und dem Kunden ein absolut positives Kundenerlebnis (Customer Experience) sowohl als Maßnahme zur Kundenbindung als auch zum Kundenaufbau zu bieten. Das vorliegende Kapitel zeigt hierfür die Erfolgskriterien für die gelungene Etablierung des Kundenfokus im eigenen Unternehmen auf. Mit dem Customer-Focus-Cycle-Modell von Fujitsu, angelehnt an den Deming-Kreislauf, wird ein allgemeingültiger Ansatz für ein mögliches Vorgehen beim Aufbau des Kundenfokus vorgestellt. Die sechs Phasen werden dabei anhand praktischer Beispiele erläutert und geben zudem Hinweise zu Methoden und Tools. Aus dem vorgestellten "Werkzeugkasten" wird ferner die Customer-Journey-Methode im Detail erläutert. Weiter soll das präsentierte Reifegradmodell Unternehmen dabei unterstützen, den eigenen Status quo festzustellen und die persönlichen Ziele auf dem Weg zur kundenzentrierten Organisation festzulegen.

  8. Why do older people oppose physician-assisted dying? A qualitative study.

    PubMed

    Malpas, Phillipa J; Wilson, Maria K R; Rae, Nicola; Johnson, Malcolm

    2014-04-01

    Physician-assisted dying at the end of life has become a significant issue of public discussion. While legally available in a number of countries and jurisdictions, it remains controversial and illegal in New Zealand. The study aimed to explore the reasons some healthy older New Zealanders oppose physician-assisted dying in order to inform current debate. Recorded interviews were transcribed and analysed by the authors after some edits had been made by respondents. In all, 11 older participants (over 65 years) who responded to advertisements placed in Grey Power magazines and a University of Auckland email list were interviewed for around 1 h and asked a number of open-ended questions. Four central themes opposing physician-assisted dying were identified from the interviews: one's personal experience with health care and dying and death, religious reasoning and beliefs, slippery slope worries and concern about potential abuses if physician-assisted dying were legalised. An important finding of the study suggests that how some older individuals think about physician-assisted dying is strongly influenced by their past experiences of dying and death. While some participants had witnessed good, well-managed dying and death experiences which confirmed for them the view that physician-assisted dying was unnecessary, those who had witnessed poor dying and death experiences opposed physician-assisted dying on the grounds that such practices could come to be abused by others.

  9. Death and help expected from nurses when dying.

    PubMed

    Shih, Fu-Jin; Gau, Meei-Ling; Lin, Yaw-Sheng; Pong, Suang-Jing; Lin, Hung-Ru

    2006-07-01

    This project was undertaken to ascertain the perceptions of a group of Taiwan's fourth-year bachelor of science in nursing (BSN) students regarding death and help expected from nurses during the dying process. Within the Chinese culture, death is one of the most important life issues. However, in many Chinese societies it is difficult for people to reveal their deepest feelings to their significant others or loved ones. It was in this context that this project was developed because little is known about how Taiwan's nursing students perceive death and the dying process. Using an open-ended, self-report questionnaire, 110 senior BSN students recorded their thoughts on: (1) their fears before physical death; (2) afterlife destinations; and (3) the help they would expect from nurses when dying. The data were analyzed using a three-layer qualitative thematic analysis. The students' reported needs during the dying process were directed towards three main goals: (1) help in reaching the 'triple targets of individual life'; (2) help in facilitating in-depth support so that both the dying person and significant others can experience a blessed farewell; and (3) help in reaching a destination in the afterlife. The results support the belief of dying as a transition occurring when life weans itself from the mortal world and prepares for an afterlife.

  10. Cascaded die mountings with spring-loaded contact-bond options

    DOEpatents

    Hsu, John S.; Adams, Donald J.; Su, Gui-Jia; Marlino, Laura D.; Ayers, Curtis W.; Coomer, Chester

    2005-08-16

    A cascaded die mounting device and method using spring contacts for die attachment, with or without metallic bonds between the contacts and the dies, is disclosed. One embodiment is for the direct refrigerant cooling of an inverter/converter carrying higher power levels than most of the low power circuits previously taught, and does not require using a heat sink.

  11. Machining of Silicon-Ribbon-Forming Dies

    NASA Technical Reports Server (NTRS)

    Menna, A. A.

    1985-01-01

    Carbon extension for dies used in forming silicon ribbon crystals machined precisely with help of special tool. Die extension has edges beveled toward narrow flats at top, with slot precisely oriented and centered between flats and bevels. Cutting tool assembled from standard angle cutter and circular saw or saws. Angle cutters cuts bevels while slot saw cuts slot between them. In alternative version, custom-ground edges or additional circular saws also cut flats simultaneously.

  12. 25 CFR 301.3 - Specifications of dies.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Specifications of dies. 301.3 Section 301.3 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER AND TURQUOISE... more mechanical than hand tools and vise. Dies shall contain only a single element of the design. ...

  13. A Hollow Extrusion Die for Big Square Tube Profiles of Al-alloy

    NASA Astrophysics Data System (ADS)

    Huang, Xuemei; Deng, Rurong

    2018-03-01

    The factors on premature failure of the traditional extrusion die for the big square tube profiles were introduced. And the characteristics of the conventional structure were analyzed. A new type of hollow die structure for these profiles was presented. And the composition elements of the new die structure were described, including its advantages. According to the comparison conventional with new die structure in use, it was shown that the new die structure has obvious advantages, it could greatly improve the die life. This is a type of die structure which is worth promoting.

  14. Margin adaptation of indirect composite inlays fabricated on flexible dies.

    PubMed

    Price, R B; Gerrow, J D

    2000-03-01

    Indirect composite restorations can be made in 1 appointment using a flexible die. Interactions between different impression materials and flexible die materials may affect the accuracy of fit and margin adaptation of the restoration. This study compared the margin adaptation of composite inlays made using the following 5 impression/flexible die material combinations; condensation silicone/polyvinyl siloxane (CS/PVS), wash viscosity polyvinyl siloxane/medium or heavy viscosity polyvinyl siloxane (PVS/PVS), irreversible hydrocolloid impression/medium viscosity polyvinyl siloxane (IH/PVS), wash viscosity polyvinyl siloxane impression/polyether (PVS/PE), with composite inlays made using a control system of a wash viscosity polyvinyl siloxane impression and a type IV stone die. For each test and control system, 10 impressions were made of a class II composite inlay preparation in a metal master die. One die was made from each impression and one composite inlay was made and finished on each die (a total of 60 inlays). Inlays were placed on the master die and the margin opening at the buccal, distal, and gingival sites was recorded with a measuring microscope (x40 magnification). The overall mean +/- SD margin openings of inlays made from the systems were as follows: PVS wash/PVS heavy viscosity 149.5 +/- 107. 4 microm; PVS wash/PVS medium viscosity 87.4 +/- 63.0 microm; IH/PVS medium viscosity 76.7 +/- 48.9 microm; CS/PVS 73.3 +/- 48.7 microm, PVS wash viscosity/PE 64.0 +/- 44.3 microm, PVS wash viscosity/stone 53.9 +/- 48.3 microm. Composite inlays made using the PVS wash viscosity/PVS heavy viscosity system had significantly larger distal, gingival, and overall mean margin openings than all other inlays (ANOVA and Fisher PLSD test; P =.05). The separating medium required between some impression and die materials did not work consistently. Composite inlays fabricated on dies made of material different than the impression material had mean buccal, distal, gingival, and

  15. [End-of-life-care and euthanasia: medical assistance in dying or help to die].

    PubMed

    Müller-Busch, H Christof

    2008-01-01

    The debate on euthanasia that has been started all over Europe, but especially in Germany has been particularly complicated by unclear and inconsistent definitions. Medical decisions in end-of-life care gain increasing importance not only for the time of death but also for the kind and quality of the dying process. Though legal regulations can help to diminish doubts about the permissibility of various measures in end-of-life care, teaching and knowledge of ethical principles, communication skills, respect, transparency and knowledge of palliative care options seem to be the most important factors in accompanying the dying professionally and with dignity and even in achieving a consented compromise when aid in hastening death is asked for.

  16. Student Nurses' Perception of Death and Dying

    ERIC Educational Resources Information Center

    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…

  17. The Right To Die. Public Talk Series.

    ERIC Educational Resources Information Center

    Pasquerella, Lynn

    This program guide on the right to die provides policy issue information where ethical concerns have a prominent place. Three positions about the right to die are presented: (1) mercy killing and assisted suicide should be legally permitted in certain cases; (2) legal status should be given to living wills and other advance directives that would…

  18. Digitalisierung als Inkubator für die Energieversorgung von morgen

    NASA Astrophysics Data System (ADS)

    Arnold, Christian; Postina, Matthias

    Neue Treiber der Digitalisierung bestimmen die Geschicke der etablierten Unternehmen im Energiebereich, dabei haben diese in vielen Fällen noch nicht einmal adäquat auf die altbekannten Treiber der Energiewende reagiert. Eine ganze Branche ist im Umbruch, alte Erlösmodelle brechen ein und Einigkeit scheint bei den Verantwortlichen nur in der Frage zu herrschen, wie in Zukunft noch Geld verdient werden kann. Dieser Beitrag erklärt die prägenden Treiber der Veränderung, analysiert die Ausgangslage und nennt Herausforderungen der Branche. Darüber hinaus legt er den Fokus auf die Betrachtung der neuen digitalen Wertschöpfung. Dazu wird ein Modell eingeführt, welches von der klassischen Wertschöpfungskette über datenbasierte Geschäftsmodelle im Energiesystem bis hin zum Internet of Smart Services reicht. Mit dem Modell geben die Autoren gleichsam Einblick in das geplante Energiewendeprojekt enera.

  19. Analysis and modeling of hot extrusion die for its service life enhancement

    NASA Astrophysics Data System (ADS)

    Akhtar, Syed Sohail

    Aluminum extrusion finds extensive application in the construction, automobile and aerospace industries. High pressures, elevated temperatures, complex and intricate section geometries lead to repeated mechanical and thermal stresses in the die and affiliated tooling. Product rework and rejects can be traced back to various defects spread over the die life cycle: die design, die manufacture and heat treatment, process parameters, inprocess die maintenance/correction and, billet type and quality. Therefore, improved and efficient service life of die and related tooling used in the extrusion press is one the most important factors in maximizing productivity and minimizing cost for ensuring the economical efficiency of an aluminum extrusion plant. How often a die has to be scrapped and replaced with a new one directly contributes to the commercial viability of producing a certain profile. The focus of the current work is on three distinct yet inter-related studies pertaining to the improvement of aluminum extrusion die. Study-A (Die Failure Analysis) is an investigation of various modes and critical failure types based on industrial data (Chapter-2 ), examination of failed dies and finite element simulation for identification of critical process parameters and design features in die fatigue-life (Chapter-3). In Study-B (Die Surface Hardening Treatment), two-stage controlled gas nitriding process for H13 steel is evaluated, both experimentally and numerically, in terms of nitrided case morphology and properties (Chapter-4) followed by experimental and numerical investigation of the effects of repeated nitriding (Chapter-5), pre-nitriding surface preparation (Chapter-6) and die profile geometry (Chapter-7) on nitriding performance in regard to die service life. In Study-C (Effect of Billet Quality on Die Life), the effect of billet quality and related influencing extrusion parameters on the die service life is investigated based on industrial data and some regression

  20. [Dying with cancer: Hollywood lessons].

    PubMed

    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.

  1. Tool & Die Technician.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Center on Education and Training for Employment.

    This document contains 23 units to consider for use in a tech prep competency profile for the occupation of tool and die technician. All the units listed will not necessarily apply to every situation or tech prep consortium, nor will all the competencies within each unit be appropriate. Several units appear within each specific occupation and…

  2. Dying to Play.

    ERIC Educational Resources Information Center

    Miller, John K.

    1998-01-01

    In August 1995, a young football player died as a result of heat exhaustion suffered on the first day of football practice in Arkansas. Spurred by this tragedy, the district made some changes that every school district with an athletic program should consider. These include using a heat-stress monitor; abandoning the practice of group physical…

  3. Dying Is Unexpectedly Positive.

    PubMed

    Goranson, Amelia; Ritter, Ryan S; Waytz, Adam; Norton, Michael I; Gray, Kurt

    2017-07-01

    In people's imagination, dying seems dreadful; however, these perceptions may not reflect reality. In two studies, we compared the affective experience of people facing imminent death with that of people imagining imminent death. Study 1 revealed that blog posts of near-death patients with cancer and amyotrophic lateral sclerosis were more positive and less negative than the simulated blog posts of nonpatients-and also that the patients' blog posts became more positive as death neared. Study 2 revealed that the last words of death-row inmates were more positive and less negative than the simulated last words of noninmates-and also that these last words were less negative than poetry written by death-row inmates. Together, these results suggest that the experience of dying-even because of terminal illness or execution-may be more pleasant than one imagines.

  4. Cost analysis of medical assistance in dying in Canada.

    PubMed

    Trachtenberg, Aaron J; Manns, Braden

    2017-01-23

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

  5. A Contextualist Thanatology: A Pragmatic Approach to Death and Dying

    ERIC Educational Resources Information Center

    Reck, Andrew J.

    1977-01-01

    Denying the value of death but accepting its reality, the author points to dying, not death, as the problematic phenomenon with which a pragmatist thanatology must deal. It is suggested that dying contains opportunities for growth--for the dying as well as for their surviving friends and relatives. (Author)

  6. Herbivory Drives the Spread of Salt Marsh Die-Off

    PubMed Central

    Bertness, Mark D.; Brisson, Caitlin P.; Bevil, Matthew C.; Crotty, Sinead M.

    2014-01-01

    Salt marsh die-off is a Western Atlantic conservation problem that has recently spread into Narragansett Bay, Rhode Island, USA. It has been hypothesized to be driven by: 1) eutrophication decreasing plant investment into belowground biomass causing plant collapse, 2) boat wakes eroding creek banks, 3) pollution or disease affecting plant health, 4) substrate hardness controlling herbivorous crab distributions and 5) trophic dysfunction releasing herbivorous crabs from predator control. To distinguish between these hypotheses we quantified these variables at 14 Narragansett Bay salt marshes where die-off intensity ranged from <5% to nearly 98%. Nitrogen availability, wave intensity and plant growth did not explain any variation in die-off. Herbivory explained 73% of inter-site variation in die-off and predator control of herbivores and substrate hardness also varied significantly with die-off. This suggests that salt marsh die-off is being largely driven by intense herbivory via the release of herbivorous crabs from predator control. Our results and those from other marsh systems suggest that consumer control may not simply be a factor to consider in marsh conservation, but with widespread predator depletion impacting near shore habitats globally, trophic dysfunction and runaway consumption may be the largest and most urgent management challenge for salt marsh conservation. PMID:24651837

  7. XML-basierte Produkt- und Prozessdaten für die Leittechnik-Projektierung

    NASA Astrophysics Data System (ADS)

    Schleipen, Miriam

    Für die Überwachung und Steuerung hochkomplexer Produktionsprozesse werden Prozessleitsysteme eingesetzt. Ständige Veränderungen zwingen Produktionsbetriebe wandlungsfähig zu sein. Entsprechend muss auch die Technik diese Flexibilität unterstützen. Jede Veränderung des Produktionsprozesses muss eingeplant, die Anlagen neu konfiguriert und projektiert werden. Dabei müssen auch neue Prozessbilder für die Bedien- und Steuerungssysteme erstellt werden. Am Fraunhofer IITB wurde ein Engineering-Framework entwickelt, das das Leitsystem automatisch projektiert und die zugehörige Prozessvisualisierung generiert. In diesem Beitrag wird das Modul vorgestellt, dass die Prozessabbilder erstellt. Neben der Visualisierung von Anlagen werden auch laufende Prozesse und bearbeitete Produkte dargestellt. So können beispielsweise Identsysteme mit der Leittechnik gekoppelt werden.

  8. Architecture for on-die interconnect

    DOEpatents

    Khare, Surhud; More, Ankit; Somasekhar, Dinesh; Dunning, David S.

    2016-03-15

    In an embodiment, an apparatus includes: a plurality of islands configured on a semiconductor die, each of the plurality of islands having a plurality of cores; and a plurality of network switches configured on the semiconductor die and each associated with one of the plurality of islands, where each network switch includes a plurality of output ports, a first set of the output ports are each to couple to the associated network switch of an island via a point-to-point interconnect and a second set of the output ports are each to couple to the associated network switches of a plurality of islands via a point-to-multipoint interconnect. Other embodiments are described and claimed.

  9. Thermal Hotspots in CPU Die and It's Future Architecture

    NASA Astrophysics Data System (ADS)

    Wang, Jian; Hu, Fu-Yuan

    Owing to the increasing core frequency and chip integration and the limited die dimension, the power densities in CPU chip have been increasing fastly. The high temperature on chip resulted by power densities threats the processor's performance and chip's reliability. This paper analyzed the thermal hotspots in die and their properties. A new architecture of function units in die - - hot units distributed architecture is suggested to cope with the problems of high power densities for future processor chip.

  10. Nano Precipitation and Hardening of Die-Quenched 6061 Aluminum Alloy.

    PubMed

    Utsunomiya, Hiroshi; Tada, Koki; Matsumoto, Ryo; Watanabe, Katsumi; Matsuda, Kenji

    2018-03-01

    Die quenching is applied to an age-hardenable aluminium alloys to obtain super-saturated solid solution. The application is advantageous because it can reduce number of manufacturing processes, and may increase strength by strain aging. If die quenching is realized in forging as well as sheet forming, it may widen industrial applicability further. In this study, Al-Mg-Si alloy AA6061 8 mm-thick billets were reduced 50% in height without cracks by die-quench forging. Supersaturated solid solution was successfully obtained. The die-quenched specimen shows higher hardness with nano precipitates at shorter aging time than the conventional water-quenched specimen.

  11. [Does the right to die with dignity exist?].

    PubMed

    Toro Flores, Rafael

    2008-12-01

    Death is one of the few certainties in human beings. This reality generates uneasiness regarding how death will occur especially in circumstances of loneliness or suffering which can become agony. In this report, the author first analyzes the existence of the right to die with dignity as a human right which takes on the nature of being a subjective right. In continuation, the author describes the existing problematic in the application of this right to die in relationship to the so-called double effect mechanism and euthanasia. The author concludes this article by proposing previous instructions or anticipated desires as ideal measures to make the right to die with dignity valid.

  12. Wie die Sonne ins Kraftwerk kommt: Solarthermische Kraftwerke

    NASA Astrophysics Data System (ADS)

    Pitz-Paal, Robert

    2004-01-01

    Solarthermische Kraftwerke sammeln wie riesige Brenngläser die Sonnenstrahlung und treiben damit eine Wärmekraftmaschine an. Drei Konstruktionsprinzipien haben sich heute durchgesetzt. Bereits im kommerziellen Einsatz sind Systeme mit schwenkbaren, verspiegelten Parabolrinnen, die das Sonnenlicht auf ein zentrales Absorberrohr konzentrieren. Durch dieses fließt ein Wärmetransportmedium. Beim Zentral-Receiver-System fokussiert ein Feld verstellbarer Spiegel das Sonnenlicht auf die Spitze eines Turms. Dort sitzt ein Receiver, den ein Wärmetransportmedium durchströmt. Für kleine, dezentrale Anlagen eignen sich Dish-Stirling-Systeme. Das sind schwenkbare, paraboloide Spiegelschüsseln mit einem Stirling-Motor im Brennpunkt. Zentral-Receiver- und Dish-Stirling-Systeme sind noch im Entwicklungsstadium.

  13. Die Interhalogenkationen [Br2F5]+ und [Br3F8].

    PubMed

    Ivlev, Sergei; Karttunen, Antti; Buchner, Magnus; Conrad, Matthias; Kraus, Florian

    2018-05-02

    Wir berichten über die Synthese und Charakterisierung der bislang einzigen Polyhalogenkationen, in denen verbrückende Fluoratome vorliegen. Das [Br2F5]+-Kation enthält eine symmetrische [F2Br-µ-F-BrF2]-Brücke, das [Br3F8]+-Kation enthält unsymmetrische µ-F-Brücken. Die Fluoronium-Ionen wurden in Form ihrer [SbF6]--Salze erhalten und Raman-, und 19F-NMR-spektroskopisch, sowie durch Röntgenbeugung am Einkristall untersucht. Quantenchemische Rechnungen, sowohl für die isolierten Kationen in der Gasphase, als auch für die Festkörper selbst, wurden durchgeführt. Populationsanalysen zeigen, dass die µ-F-Atome die am stärksten negativ partialgeladenen Atome der Kationen sind. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

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

    PubMed

    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.

  15. Cause and place of death in patients dying with colorectal cancer.

    PubMed

    Jones, O M; John, S K P; Horseman, N; Lawrance, R J; Fozard, J B J

    2007-03-01

    Few studies on colorectal cancer look at the one-third of patients for whom treatment fails and who need a management strategy for death. This paper has examined the mode and place of death in patients with colorectal cancer. This study was a review of 209 deaths, analysed between January 2001 and September 2004 by retrospective review of a prospectively collected database. A total of 118 patients (group 1) had undergone resection of their primary colorectal cancer, 20 (group 2) had had a defunctioning stoma or bypass surgery and the remaining 71 patients (group 3) had either had no surgery, an open and close laparotomy or had a colonic stent. One hundred and fifty-six (75%) patients died of colorectal cancer with the remainder dying of other causes. The number of admissions to hospital and the number of days spent in hospital from diagnosis to death were greatest in group 1. Overall, only 34 patients (22%) dying from colorectal cancer died at home. Forty (26%) died in hospital and 70 (45%) died in a palliative care unit. Patients dying from colorectal cancer who undergo surgical resection of their primary tumour spend more time between diagnosis and death in hospital. They are also more likely to die in hospital than patients treated by surgical palliation or nonsurgically. Patients who are treated palliatively from the outset (group 3) are most likely to die at home. If hospital is accepted as an appropriate place for death from colorectal cancer, then greater provision for this should be made.

  16. The narrative labyrinth of violent dying.

    PubMed

    Rynearson, E K

    2005-05-01

    This essay outlines the dynamics of retelling the violent death of a loved one and the narrative "dilemma" of vulnerable family members fixated on retelling. To counter this fixation, the author presents a mythic retelling of violent death (the Myth of Theseus) as narrative basis for developing a restorative retelling. The essay begins by exploring the deformed and deforming structure of the violent dying story, then details the dynamics of its retelling and concludes by presenting a restorative retelling model for family members who cannot release themselves from the story for months or years after the violent dying.

  17. Long-Wave Radiation Divergence over Water and Land from Measurement and Calculation (Die Langwellige Strahlungsdivergenz ueber Wasser und ueber dem Festen Boden nach Messung und Rechnung),

    DTIC Science & Technology

    surface temperature field. If these are eliminated, which is relatively simple over a water surface, the differences between calculated and measured...divergences at these levels is less than 20%, on the average. The relative variation of the divergence with height is somewhat greater over water than over land, due to the different temperature profiles. (Author)

  18. A study on die wear model of warm and hot forgings

    NASA Astrophysics Data System (ADS)

    Kang, J. H.; Park, I. W.; Jae, J. S.; Kang, S. S.

    1998-05-01

    Factors influencing service lives of tools in warm and hot forging processes are wear, mechanical fatigue, plastic deformation and thermal fatigue, etc. Wear is the predominant factor for tool failure among these. To predict tool life by wear, Archard's model where hardness is considered as constant or function of temperature is generally applied. Usually hardness of die is a function of not only temperature but operating time of die. To consider softening of die by repeated operation it is necessary to express hardness of die by a function of temperature and time. In this study wear coefficients were measured for various temperatures and heat treatment for H13 tool steel. Also by experiment of reheating of die, die softening curves were obtained. From experimental results, relationships between tempering parameters and hardness were established to investigate effects of hardness decrease by the effect of temperatures and time. Finally modified Archard's wear model in which hardness is considered to be a function of main tempering curve was proposed. And finite element analyses were conducted by adopting suggested wear model. By comparisons of simulations and real profiles of worn die, proposed wear model was verified.

  19. Die Grundlagen der Fernsehtechnik: Systemtheorie und Technik der Bildübertragung

    NASA Astrophysics Data System (ADS)

    Mahler, Gerhard

    Umfassende Einführung in die Grundlagen der Bewegtbild-Übertragung von den Anfängen bis zum heutigen Stand des digitalen Fernsehens mit einer aus der Praxis entstandenen systemtheoretischen Analyse. Die kompakte und anschaulich bebilderte Darstellung mit elementaren mathematischen Beschreibungen macht es dem Leser leicht, sich in die Bildübertragungstechnik einzuarbeiten. Thematische Einheiten erweitern den Wissensstoff - u.a. zu den Themen visuelle Wahrnehmung, mehrdimensionale Signaldarstellung, Farbmetrik, Digitalisierung, Elektronenoptik - und zeigen deren Anwendung auf die elektronische Bildübertragung.

  20. Milling strategies evaluation when simulating the forming dies' functional surfaces production

    NASA Astrophysics Data System (ADS)

    Ižol, Peter; Tomáš, Miroslav; Beňo, Jozef

    2016-05-01

    The paper deals with selection and evaluation of milling strategies, available in CAM systems and applicable when complicated shape parts are produced, such as forming dies. A method to obtain samples is proposed and this stems from real forming die surface machined by proper strategies. The strategy applicability for the whole part - forming die - is reviewed by the particular specimen evaluation. The presented methodology has been verified by machining model die and comparing it to the production procedure proposed in other CAM systems.

  1. Nursing the dying: implications of Kübler-Ross' staging theory.

    PubMed

    Germain, C P

    1980-01-01

    Society's failure to value the work of nurses, the professionals most frequently involved in the care of the dying, is attributed to a cultural definition of nursing as a second-class occupation and the public's need to deny the realities of the suffering and indignities often associated with the process of dying. Efforts within the field of nursing to improve the care of the dying, by shifting emphasis from a narrow physical focus to a more holistic patient and family focus, preceded the past decade's contributions of Elisabeth Kübler-Ross. Although her staging theory has been cited as having limitations in development and in interpretation, Kübler-Ross' influence towards increasing awareness of the needs of the dying and others experiencing major losses has been substantial as evidenced by many references to staging theory in nursing literature, by a marked increase in attention to holistic care of the dying in the basic and continuing education programs of nursing, and by specialty role development in nursing care of the dying. This decade has also witnessed the major growth of professionalism in nursing, including strides towards professional autonomy. Conflict with the traditional pattern of medical dominance and bureacratic constraints in institutions is inevitable, especially when the medical goal of cure is not attainable. Change to an interdisciplinary model of care is viewed as essential for optimal care of the dying and their families.

  2. The right to be allowed to die.

    PubMed Central

    Campbell, A G

    1983-01-01

    The unbridled use of modern medical skills and technology in preserving life at all costs has stimulated interest in expressing a 'right to die' by the legally competent patient who is anxious to protect his autonomy. Some recent decisions by American courts are seen to threaten this 'right to die' of competent patients and imply that legally incompetent patients including children should not have this right under any circumstances, even when expressed on their behalf by guardians, nearest relatives or parents. It is argued that this is contrary to 'natural justice' as viewed by most people. It should be possible to develop procedures which are protective of the basic 'right to life' of the incompetent yet will recognise circumstances where they could be allowed to die. This paper was presented at the 1983 annual conference of the London Medical Group, 'Human Rights in Medicine'. PMID:6620316

  3. When a Baby Dies.

    ERIC Educational Resources Information Center

    Church, Martha Jo; And Others

    Written especially for grieving mothers whose babies have died, this booklet offers an overview of stages and experiences through which bereaved parents commonly pass. Specifically, the text is intended to give comfort to bereaved parents, offer insight into the grieving process, and provide thoughts on leave-taking ceremonies. The first section…

  4. Dying in hospital: socioeconomic inequality trends in England

    PubMed Central

    Asaria, Miqdad; Sheringham, Jessica; Stone, Patrick; Raine, Rosalind; Cookson, Richard

    2017-01-01

    Objective To describe trends in socioeconomic inequality in the proportion of deaths occurring in hospital, during a period of sustained effort by the NHS in England to improve end of life care. Methods Whole-population, small area longitudinal study involving 5,260,871 patients of all ages who died in England from 2001/2002 to 2011/2012. Our primary measure of inequality was the slope index of inequality. This represents the estimated gap between the most and least deprived neighbourhood in England, allowing for the gradient in between. Neighbourhoods were geographic Lower Layer Super Output Areas containing about 1500 people each. Results The overall proportion of patients dying in hospital decreased from 49.5% to 43.6% during the study period, after initially increasing to 52.0% in 2004/2005. There was substantial ‘pro-rich’ inequality, with an estimated difference of 5.95 percentage points in the proportion of people dying in hospital (confidence interval 5.26 to 6.63), comparing the most and least deprived neighbourhoods in 2011/2012. There was no significant reduction in this gap over time, either in absolute terms or relative to the mean, despite the overall reduction in the proportion of patients dying in hospital. Conclusions Efforts to reduce the proportion of patients dying in hospital in England have been successful overall but did not reduce inequality. Greater understanding of the reasons for such inequality is required before policy changes can be determined. PMID:28429981

  5. Christopher Hitchens' Public Dying: Toward a Secular-Humanist Ars Moriendi?

    PubMed

    Brennan, Michael

    2018-06-01

    This article explores the public dying of journalist, writer, provocateur, public intellectual, and renowned atheist, Christopher Hitchens. It does so primarily through an analysis of television interviews given by Hitchens following his diagnosis with esophageal cancer in June 2010. Four key themes are identified as emerging from analysis of the interviews: (a) Hitchens' explicit sense of mission in challenging myths and superstitions surrounding cancer, dying, and death; (b) the personal experience of terminal illness and dying and the particular way (or style of dying) by which it is approached; (c) issues of regret and a life well lived; and (d) questions surrounding religion, the afterlife, and possibility of deathbed conversion. In light of the claim that ours is a culture in search of an ars moriendi, the article examines what we can learn from Hitchens' auto/pathographic interviews (and writings) and the extent to which this rational-humanist, atheistic, and stoical style of dying provides a useable "template" for others nearing the end of life.

  6. Fundamental studies on a novel die concept for round-point shear-clinching

    NASA Astrophysics Data System (ADS)

    Hörhold, Réjane; Müller, Martin; Merklein, Marion; Meschut, Gerson

    2016-10-01

    A newly-developed round-point shear-clinching technology could increase the use of different materials like well formable aluminium and hardly formable ultra-high-strength steels (UHSS). This innovative technology joins in a single-stage process without any pilot-hole, surface pre-treatment or auxiliary joining part. The combination of an inner and outer punch realises an indirect cutting operation of the die-sided material, whereas the punch-sided material remains unharmed. The current die-sided tool set acts as a cutting die and enables a radial extrusion of the punch-sided material after being drawn though the created hole in the UHSS. The die has a fixed die depth. After ejecting the joined components, the slug has to be removed from the top of the spring-loaded anvil. The novel die concept investigated in this paper offers the possibility to push the slug continuously through the die in the joining direction. The removed slugs remain inside the die, so manual removal is unnecessary. The one-parted tool is supposed to be more robust than the multi-parted one that is currently used. This paper represents the task to evaluate the geometry of a useful shear-clinching die concept. To reduce the experimental effort, FEM should assist the development of the most promising approach. To quantify the success, conventional shear-clinching with opening die acts as a reference. The results show the high potential and the raison d'être of shear-clinching technologies as a mechanical joining technology for future multimaterial applications especially for UHSS.

  7. Spatio-temporal development of vegetation die-off in a submerging coastal marsh

    USGS Publications Warehouse

    Schepers, Lennert; Kirwan, Matthew; Guntenspergen, Glenn R.; Temmerman, Stijn

    2017-01-01

    In several places around the world, coastal marsh vegetation is converting to open water through the formation of pools. This is concerning, as vegetation die-off is expected to reduce the marshes' capacity to adapt to sea level rise by vegetation-induced sediment accretion. Quantitative analyses of the spatial and temporal development of marsh vegetation die-off are scarce, although these are needed to understand the bio-geomorphic feedback effects of vegetation die-off on flow, erosion, and sedimentation. In this study, we quantified the spatial and temporal development of marsh vegetation die-off with aerial images from 1938 to 2010 in a submerging coastal marsh along the Blackwater River (Maryland, U.S.A). Our results indicate that die-off begins with conversion of marsh vegetation into bare open water pools that are relatively far (> 75 m) from tidal channels. As vegetation die-off continues, pools expand, and new pools emerge at shorter and shorter distances from channels. Consequently larger pools are found at larger distances from the channels. Our results suggest that the size of the pools and possibly the connection of pools with the tidal channel system have important bio-geomorphic implications and aggravate marsh deterioration. Moreover, we found that the temporal development of vegetation die-off in moderately degraded marshes is similar as the spatial die-off development along a present-day gradient, which indicates that the contemporary die-off gradient might be considered a chronosequence that offers a unique opportunity to study vegetation die-off processes.

  8. Killing and letting die: hidden value assumptions.

    PubMed

    Atkinson, G

    1983-01-01

    In this paper I argue for several related theses: first, that the distinction between killing and letting die, as it is drawn by ordinary persons in ordinary contexts, is more complex than is generally understood; second, that the key feature of this complexity lies in the presence of a hidden normative component in what appears to be a straightforwardly descriptive distinction; and, third, that this complexity renders the killing/letting die distinction an inadequate and hazardous guide for moral reasoning.

  9. Die Starter: A New System to Manage Early Feasibility in Sheet Metal Forming

    NASA Astrophysics Data System (ADS)

    Narainen, Rodrigue; Porzner, Harald

    2016-08-01

    Die Starter, a new system developed by ESI Group, allows the user to drastically reduce the number of iterations during the early tool process feasibility. This innovative system automatically designs the first quick die face, generating binder and addendum surfaces (NURBS surfaces) by taking account the full die process. Die Starter also improves the initial die face based on feasibility criteria (avoiding splits, wrinkles) by automatically generating the geometrical modifications of the binder and addendum and the bead restraining forces with minimal material usage. This paper presents a description of the new system and the methodology of Die Starter. Some industrial examples are presented from the part geometry to final die face including automatic developed flanges, part on binder and inner binder.

  10. The Dying Child: The Management of the Child or Adolescent Who is Dying.

    ERIC Educational Resources Information Center

    Easson, William M.

    Primarily describing the child who must endure a lengthy terminal illness and prolonged period of dying, the text presents the developmental stages of the child's understanding of his own death. Characteristics of the child at various ages (preschool, elementary school, and adolescent) are examined in areas such as hospitalization effects,…

  11. Strippable grid facilitates removal of grid-surfaced conical workpiece from die

    NASA Technical Reports Server (NTRS)

    Ruppe, E. P.

    1966-01-01

    Female die facilitates the removal of a sheet metal structure from a die used for explosive forming of the metal. The female die consists of a smooth conical frustum made of fiber glass with a cured epoxy-resin surface on which a molded grid pattern made of a polyurethane resin is overlaid.

  12. A Covering Type Extrusion Die with Twin Cavities for Semi-Hollow Al-Profiles

    NASA Astrophysics Data System (ADS)

    Deng, Rurong; Huang, Xuemei

    2018-03-01

    A new structure named covering type with twin cavities in a die for the semi-hollow aluminum profiles was present. The determination of structure parameters was introduced in detail. Mainly including the selection of the machine, the arrangement of portholes, the structure design of chamber and the selection of bearing. The method of checking the die strength was introduced. According to the extrusion results, the structure of the traditional solid die, the porthole die with single cavity and the covering type structure with twin cavities were compared. The characteristics of the latter structure were simple and easy to process. The practical application shows that the new die structure can enhance the die life, improve the production efficiency and reduce the cost. The high precision and the surface brightness of the profiles were obtained. The structure is worth promoting. The aim is to provide reliable data and reference for the further research and development of this technology on the extrusion die with multi-cavities in a die.

  13. Microstructures and properties of aluminum die casting alloys

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    M. M. Makhlouf; D. Apelian; L. Wang

    1998-10-01

    This document provides descriptions of the microstructure of different aluminum die casting alloys and to relate the various microstructures to the alloy chemistry. It relates the microstructures of the alloys to their main engineering properties such as ultimate tensile strength, yield strength, elongation, fatigue life, impact resistance, wear resistance, hardness, thermal conductivity and electrical conductivity. Finally, it serves as a reference source for aluminum die casting alloys.

  14. Courts to look again at assisted dying law.

    PubMed

    Griffith, Richard

    2017-05-02

    A man with motor neurone disease has been granted permission by the Court of Appeal to seek judicial review the criminalisation of assisted dying under the Suicide Act 1961, section 2(1). In this article, Richard Griffith reviews the Court of Appeal's decision in R (on the application of Conway) v Secretary of State for Justice [2017] and considers arguments for and against decriminalising assisted dying.

  15. Numerical investigation of the effect of friction conditions to increase die life

    NASA Astrophysics Data System (ADS)

    Mutlu, M. O.; Guleryuz, C. G.; Parlar, Z.

    2017-02-01

    The standard die materials in aluminium extrusion offer good mechanical properties like high tempering resistance, high strength and ductility. On the other hand, they struggle with the problem of sliding wear. As a result, there is a growing interest in using surface treatment techniques to increase the wear resistance of extrusion dies. In this study, it is aimed to observe the effects of the different friction conditions on material flow and contact pressure in extrusion process. These friction conditions can be obtained with the application of a variety of surface treatment. In this way, it is expected to decrease the friction force on the die bearing area and to increase the homogeneity of the material flow which will result in the increase of the quality of the extrudate as well as the improvement of the process economically by extending die life. For this purpose, an extrusion process is simulated with a finite element software. A die made of 1.2344 hot work tool steel-commonly used die material for aluminium extrusion process- has been modelled and Al 1100 alloy used as billet material. Various friction factor values defined on the die surface under the same process parameters and effects of changing frictional conditions on the die and the extrusion process have been discussed.

  16. Von Start-ups lernen - Methoden und Entwicklungsprozesse, die Jungunternehmen erfolgreich machen

    NASA Astrophysics Data System (ADS)

    Böhme, Eckhart

    Die Start-up-Bewegung bringt beständig sog. Disruptoren hervor, die jede Branche betreffen und so gut wie keinen Lebensbereich auslassen. Diese Jungunternehmen, insbesondere aus der Softwarebranche, verfügen zwar nicht über Ressourcen wie etablierte Unternehmen, sie sind jedoch agil, "hungrig", können frei von "Ballast" agieren und treiben die Digitalisierung aller Branchen voran. Aber auch Start-ups können nicht einfach ungetestete Ideen in erfolgreiche Produkte oder Dienstleistungen umwandeln und ihren Erfolg dem Zufall überlassen. Erfolgreiche Jungunternehmen folgen vielmehr einem strukturierten Prozess, um marktgetestete Nutzenversprechen und Geschäftsmodelle zu entwickeln. Zunehmend adaptieren etablierte Unternehmen innovative Entwicklungsprozesse und Methoden. Die Fragestellung für Energieversorgungsunternehmen (EVUs) lautet, welche Methoden, Werkzeuge und Entwicklungsprozesse, die heute bei vielen Start-ups eingesetzt werden, sie aufgreifen können, um das Unternehmen gegenüber Disruptoren robust zu machen?

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

    PubMed

    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.

  18. Development and Demonstration of Adanced Tooling Alloys for Molds and Dies

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kevin M. McHugh; Enrique J. Lavernia

    2006-01-01

    This report summarizes research results in the project Development and Demonstration of Advanced Tooling Alloys for Molds and Dies. Molds, dies and related tooling are used to manufacture most of the plastic and metal products we use every day. Conventional fabrication of molds and dies involves a multiplicity of machining, benching and heat treatment unit operations. This approach is very expensive and time consuming. Rapid Solidifcation Process (RSP) Tooling is a spray-forming technology tailored for producing molds and dies. The appraoch combines rapid solidifcation processing and net-shape materials processing in a single step. An atomized spray of a tool-forming alloy,more » typically a tool steel, is deposited onto an easy-to-form tool pattern to replicate the pattern's shape and surface features. By so doing, the approach eliminates many machining operations in conventional mold making, significantly reducing cost, lead time and energy. Moreover, rapid solidification creates unique microstructural features by suppressing carbide precipitation and growth, and creating metastable phases. This can result in unique material properties following heat treatment. Spray-formed and aged tool steel dies have exhibited extended life compared to conventional dies in many forming operations such as forging, extrusion and die casting. RSP Tooling technolocy was commercialized with the formation of RSP Tooling, LLC in Solon, Oh.« less

  19. Compaction die for forming a solid annulus on a right circular cylinder. [Patent application

    DOEpatents

    Harlow, J.L.

    1981-09-14

    A compacting die is disclosed wherein the improvement comprises providing a screen in the die cavity, the screen being positioned parallel to the side walls of said die and dividing the die cavity into center and annular compartments. In addition, the use of this die in a method for producing an annular clad ceramic fuel material is disclosed.

  20. Living and Dying: A Window on (Christian) Children's Spirituality

    ERIC Educational Resources Information Center

    Champagne, Elaine

    2008-01-01

    Faith and beliefs about living and dying are fundamental constituents of spiritual development. However, children are seldom asked to talk about their experiences of life and death. This article has a twofold purpose. It first describes children's expressions on living and dying, as heard during a newly developed programme which encourages…

  1. Clinical nurses' attitudes towards death and caring for dying patients in China.

    PubMed

    Wang, Liping; Li, Chaxiang; Zhang, Qiongling; Li, YaJie

    2018-01-02

    To examine Chinese clinical nurses' attitudes towards death and caring for dying patients, and to examine the relationships between clinical nurses' attitudes towards death and caring for dying patients. A convenience sample of 770 clinical nurses from 15 hospitals in China. All participants completed the Chinese version of the Frommelt Attitude Toward Care of the Dying Scale, Form B (FATCOD-B-C), the Chinese version of the Death Attitude Profile-Revised (DAP-R-C), and a demographic questionnaire. The mean score of the FATCOD-B-C items was 95.62 (SD = 7.45). The majority of Chinese clinical nurses were likely to provide care for the dying person's family (mean = 3.77), but did not have a positive attitude towards communication with the dying person(mean = 2.62). The majority of Chinese clinical nurses showed low scores on death avoidance (mean=1.96) and natural acceptance (mean = 1.61), and most of them viewed death as a passageway to a happy afterlife (mean = 4.33). Attitudes towards caring for dying patients were significantly negatively correlated with fear of death (r = -0.120) and positively correlated with approach acceptance (r = 0.127) and natural acceptance (r = 0.117). Factors that predicted clinical nurses' attitudes towards the care of dying patients included education level, fear of death, approach acceptance, religious beliefs, previous education on death and dying, natural acceptance, professional title, and experience with death or dying patients, which accounted for 18.7% of the variance. Nurses' personal attitudes towards death were associated with their attitudes towards the care of dying patients. Training and educational programmes for clinical nurses should take into consideration nurses' personal attitudes towards death as well as their cultural backgrounds and religious beliefs.

  2. Dying with motor neurone disease, what can we learn from family caregivers?

    PubMed Central

    Ray, Robin A.; Brown, Janice; Street, Annette F.

    2012-01-01

    Abstract Background  Increasingly, people with neurodegenerative illness are cared for at home until close to death. Yet, discussing the reality of dying remains a social taboo. Objective  To examine the ways, family caregivers of people living with motor neurone disease (MND) experienced the dying of their relative and to identify how health practitioners can better prepare families for end‐of‐life care. Design  Secondary analysis was undertaken on data sets generated from two longitudinal qualitative studies employing similar data collection and analysis methods. Combining data sets increased participant numbers in a low incidence disease group. Setting and participants  Primary studies were undertaken with family caregivers in England and Australia. Interview and observational data were collected mostly in home. Participants who discussed dying and death formed the sample for secondary analysis. Results  Combined data revealed four major themes: planning for end of life, unexpected dying, dignity in the dying body and positive end to MND. Despite short survival predictions, discussions among family members about dying were often sporadic and linked to loss of hope. Effective planning for death assisted caregivers to manage the final degenerative processes of dying. When plans were not effectively communicated or enacted, capacity to preserve personhood was reduced. Discussion and Conclusion  Returning death and dying to social discourse will raise the level of community awareness and normalize conversations about end‐of‐life care. Strategies for on‐going, effective communication that facilitates advance care planning among patients, their families and practitioners are essential to improve dying and death for people with MND and their family caregivers. PMID:22512686

  3. Regional vegetation die-off in response to global-change-type drought

    USGS Publications Warehouse

    Breshears, D.D.; Cobb, N.S.; Rich, P.M.; Price, K.P.; Allen, Craig D.; Balice, R.G.; Romme, W.H.; Kastens, J.H.; Floyd, M. Lisa; Belnap, J.; Anderson, J.J.; Myers, O.B.; Meyer, Clifton W.

    2005-01-01

    Future drought is projected to occur under warmer temperature conditions as climate change progresses, referred to here as global-change-type drought, yet quantitative assessments of the triggers and potential extent of drought-induced vegetation die-off remain pivotal uncertainties in assessing climate-change impacts. Of particular concern is regional-scale mortality of overstory trees, which rapidly alters ecosystem type, associated ecosystem properties, and land surface conditions for decades. Here, we quantify regional-scale vegetation die-off across southwestern North American woodlands in 2002-2003 in response to drought and associated bark beetle infestations. At an intensively studied site within the region, we quantified that after 15 months of depleted soil water content, >90% of the dominant, overstory tree species (Pinus edulis, a piñon) died. The die-off was reflected in changes in a remotely sensed index of vegetation greenness (Normalized Difference Vegetation Index), not only at the intensively studied site but also across the region, extending over 12,000 km2 or more; aerial and field surveys confirmed the general extent of the die-off. Notably, the recent drought was warmer than the previous subcontinental drought of the 1950s. The limited, available observations suggest that die-off from the recent drought was more extensive than that from the previous drought, extending into wetter sites within the tree species' distribution. Our results quantify a trigger leading to rapid, drought-induced die-off of overstory woody plants at subcontinental scale and highlight the potential for such die-off to be more severe and extensive for future global-change-type drought under warmer conditions.

  4. Regional vegetation die-off in response to global-change-type drought

    PubMed Central

    Breshears, David D.; Cobb, Neil S.; Rich, Paul M.; Price, Kevin P.; Allen, Craig D.; Balice, Randy G.; Romme, William H.; Kastens, Jude H.; Floyd, M. Lisa; Belnap, Jayne; Anderson, Jesse J.; Myers, Orrin B.; Meyer, Clifton W.

    2005-01-01

    Future drought is projected to occur under warmer temperature conditions as climate change progresses, referred to here as global-change-type drought, yet quantitative assessments of the triggers and potential extent of drought-induced vegetation die-off remain pivotal uncertainties in assessing climate-change impacts. Of particular concern is regional-scale mortality of overstory trees, which rapidly alters ecosystem type, associated ecosystem properties, and land surface conditions for decades. Here, we quantify regional-scale vegetation die-off across southwestern North American woodlands in 2002-2003 in response to drought and associated bark beetle infestations. At an intensively studied site within the region, we quantified that after 15 months of depleted soil water content, >90% of the dominant, overstory tree species (Pinus edulis, a piñon) died. The die-off was reflected in changes in a remotely sensed index of vegetation greenness (Normalized Difference Vegetation Index), not only at the intensively studied site but also across the region, extending over 12,000 km2 or more; aerial and field surveys confirmed the general extent of the die-off. Notably, the recent drought was warmer than the previous subcontinental drought of the 1950s. The limited, available observations suggest that die-off from the recent drought was more extensive than that from the previous drought, extending into wetter sites within the tree species' distribution. Our results quantify a trigger leading to rapid, drought-induced die-off of overstory woody plants at subcontinental scale and highlight the potential for such die-off to be more severe and extensive for future global-change-type drought under warmer conditions. PMID:16217022

  5. Key factors affecting dying children and their families.

    PubMed

    Hinds, Pamela S; Schum, Lisa; Baker, Justin N; Wolfe, Joanne

    2005-01-01

    The death of a child alters the life and health of others immediately and for the rest of their lives. How a child dies influences parents' abilities to continue their role functions as well as siblings' abilities to make and maintain friendships, and may be the basis for health care providers' decisions to exit direct care roles. Thus, facilitating a "good death"-an obvious care priority for all involved with the dying child-ought also to be a priority for the health of bereaved families and affected health care providers. Making this a care priority is complicated by a serious lack of data, as details of the last hours or weeks of a dying child or adolescent's life are largely unknown. The purpose of this paper is to identify key factors that affect the course of dying children and adolescents and that of their bereaved survivors, and to link those key factors to needed research that could produce clinically relevant findings to improve the care of these patients. Key factors described here include suffering (physical, psychological, and spiritual), communication, decision making, prognostic ambiguities, ability of the seriously ill child to give assent to research participation, and educational preparation of health care providers to give competent end-of-life care.

  6. Aerial image based die-to-model inspections of advanced technology masks

    NASA Astrophysics Data System (ADS)

    Kim, Jun; Lei, Wei-Guo; McCall, Joan; Zaatri, Suheil; Penn, Michael; Nagpal, Rajesh; Faivishevsky, Lev; Ben-Yishai, Michael; Danino, Udy; Tam, Aviram; Dassa, Oded; Balasubramanian, Vivek; Shah, Tejas H.; Wagner, Mark; Mangan, Shmoolik

    2009-10-01

    Die-to-Model (D2M) inspection is an innovative approach to running inspection based on a mask design layout data. The D2M concept takes inspection from the traditional domain of mask pattern to the preferred domain of the wafer aerial image. To achieve this, D2M transforms the mask layout database into a resist plane aerial image, which in turn is compared to the aerial image of the mask, captured by the inspection optics. D2M detection algorithms work similarly to an Aerial D2D (die-to-die) inspection, but instead of comparing a die to another die it is compared to the aerial image model. D2M is used whenever D2D inspection is not practical (e.g., single die) or when a validation of mask conformity to design is needed, i.e., for printed pattern fidelity. D2M is of particular importance for inspection of logic single die masks, where no simplifying assumption of pattern periodicity may be done. The application can tailor the sensitivity to meet the needs at different locations, such as device area, scribe lines and periphery. In this paper we present first test results of the D2M mask inspection application at a mask shop. We describe the methodology of using D2M, and review the practical aspects of the D2M mask inspection.

  7. Proper care for the dying: a critical public issue.

    PubMed Central

    Crispell, K R; Gomez, C F

    1987-01-01

    The ability of the medical profession to sustain life, or more appropriately, to prolong dying, in patients with terminal illness, creates a most complex and controversial situation for all involved: the patient, if mentally alert; the patient's family; and the medical care team including physicians, nurses and attendants. This situation is especially complex in large acute care hospitals where medical and nursing students, residents and house officers receive advanced medical training. A major problem, prolonging the dying of the terminally ill, with its medical, legal, ethical and economic complexities now confronts American society. The problem is particularly acute in teaching hospitals, in which one finds a disproportionate number of terminally ill patients. The ability to work at these questions as a community rather than as adversaries will determine much about the ability of the health care system to respect the dignity and autonomy of those who seek aid and comfort when faced with serious illness and impending death. Better communication between the physicians, health care providers, the lawyers and ethicists must be developed in order to solve these problems. Over the next ten years society and our elected representatives will be making very demanding decisions about the use of the health dollar. One possible way to prevent increasing costs is to reach significant agreement on the proper care of the dying. Proper care for the dying is being considered, discussed, and evaluated by very thoughtful people. It is not governments which should decide who is to live or who is to die. There is the serious problem of the 'slippery slope' to euthanasia by omission if cost containment becomes the major force in formulating policy on the proper care of the dying. PMID:3612698

  8. The dying neonate: family-centered end-of-life care.

    PubMed

    De Lisle-Porter, Martine; Podruchny, Ann Marie

    2009-01-01

    There is a need in the NICU for an end-of-life care guideline that nurses can follow when working with dying infants and their families. Maintaining intravenous access to relieve the infant's pain, communicating sensitively to the family, and creating precious, everlasting memories are goals that should be part of every dying infant's care. The nurse's ability to partner with the family in caring for the infant is integral to helping the family take the first steps in their grief journey. Evidence-based literature provides NICU nurses with the knowledge that they are the facilitators of end-of-life care for dying infants. New mothers and fathers are not aware of the caring parental tasks they can perform for their dying baby. They look to and depend on their infant's nurses to encourage them. The guideline included here provides nurses with a tool for ensuring that families have the opportunity to create memories that will not only help them with their immediate pain, but also comfort them for a lifetime.

  9. Solid explosive plane-wave lenses pressed-to-shape with dies

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Olinger, B.

    2007-11-01

    Solid-explosive plane-wave lenses 1", 2" and 4¼" in diameter have been mass-produced from components pressed-to-shape with aluminum dies. The method used to calculate the contour between the solid plane-wave lens components pressed-to-shape with the dies is explained. The steps taken to press, machine, and assemble the lenses are described. The method of testing the lenses, the results of those tests, and the corrections to the dies are reviewed. The work on the ½", 8", and 12" diameter lenses is also discussed.

  10. Dying scenarios improve recall as much as survival scenarios.

    PubMed

    Burns, Daniel J; Hart, Joshua; Kramer, Melanie E

    2014-01-01

    Merely contemplating one's death improves retention for entirely unrelated material learned subsequently. This "dying to remember" effect seems conceptually related to the survival processing effect, whereby processing items for their relevance to being stranded in the grasslands leads to recall superior to that of other deep processing control conditions. The present experiments directly compared survival processing scenarios with "death processing" scenarios. Results showed that when the survival and dying scenarios are closely matched on key dimensions, and possible congruency effects are controlled, the dying and survival scenarios produced equivalently high recall levels. We conclude that the available evidence (cf. Bell, Roer, & Buchner, 2013; Klein, 2012), while not definitive, is consistent with the possibility of overlapping mechanisms.

  11. Die Energiebranche am Beginn der digitalen Transformation: aus Versorgern werden Utilities 4.0

    NASA Astrophysics Data System (ADS)

    Doleski, Oliver D.

    Die traditionelle Energieversorgung befindet sich in einer Zäsur. Das seit Jahrzehnten bewährte und stabile Geschäftsmodell einer zuverlässig planbaren, zentralen Energieerzeugung mit anschließender unidirektionaler Verteilung geriet spätestens seit der Energiewende des Jahres 2011 immer mehr unter Druck. Angesichts fortschreitender Digitalisierung und Dezentralisierung einerseits und gestiegener Erwartungshaltung der Kunden gegenüber "ihrem" Versorger andererseits sieht sich die Energiebranche heute einem epochalen Transformationsprozess gegenübergestellt. Bei diesem entwickeln sich aus den monopolistischen Versorgern des 19. und 20. Jahrhunderts (Utility 1.0), über die liberalisierten Energieversorgungsunternehmen (Utility 2.0) und Energiedienstleistungsunternehmen (Utility 3.0) heutiger Prägung, die digitalen Energiedienstleistungsunternehmen (Utility 4.0) von morgen. Oliver D. Doleski beschränkt sich in seinem Beitrag nicht auf die reine Beschreibung dieses Veränderungsprozesses an sich. Vielmehr werden darüber hinaus sowohl die mit dieser Entwicklung verbundenen übergeordneten Ziele als auch die wesentlichen Anforderungen an erfolgreiche Utilities 4.0 skizziert. Das Kapitel endet mit einem prägnanten Überblick profitabler Betätigungsfelder, die zur Sicherung der ökonomischen Zukunft von Energiekonzernen, Regionalversorgern und Stadtwerken beitragen können.

  12. New Lubricant for Pressure Die Casting,

    DTIC Science & Technology

    synthetic acids, finely dispersed graphite preparations, etc. The new lubricants are not inferior in their properties to the well known foreign lubricants antilov, olea , and emtek used in pressure die casting.

  13. 9 CFR 309.3 - Dead, dying, disabled, or diseased and similar livestock.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Dead, dying, disabled, or diseased and... AND VOLUNTARY INSPECTION AND CERTIFICATION ANTE-MORTEM INSPECTION § 309.3 Dead, dying, disabled, or diseased and similar livestock. (a) Livestock found to be dead or in a dying condition on the premises of...

  14. 9 CFR 309.3 - Dead, dying, disabled, or diseased and similar livestock.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Dead, dying, disabled, or diseased and... AND VOLUNTARY INSPECTION AND CERTIFICATION ANTE-MORTEM INSPECTION § 309.3 Dead, dying, disabled, or diseased and similar livestock. (a) Livestock found to be dead or in a dying condition on the premises of...

  15. 9 CFR 309.3 - Dead, dying, disabled, or diseased and similar livestock.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Dead, dying, disabled, or diseased and... AND VOLUNTARY INSPECTION AND CERTIFICATION ANTE-MORTEM INSPECTION § 309.3 Dead, dying, disabled, or diseased and similar livestock. (a) Livestock found to be dead or in a dying condition on the premises of...

  16. 9 CFR 309.3 - Dead, dying, disabled, or diseased and similar livestock.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Dead, dying, disabled, or diseased and... AND VOLUNTARY INSPECTION AND CERTIFICATION ANTE-MORTEM INSPECTION § 309.3 Dead, dying, disabled, or diseased and similar livestock. (a) Livestock found to be dead or in a dying condition on the premises of...

  17. 9 CFR 309.3 - Dead, dying, disabled, or diseased and similar livestock.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Dead, dying, disabled, or diseased and... AND VOLUNTARY INSPECTION AND CERTIFICATION ANTE-MORTEM INSPECTION § 309.3 Dead, dying, disabled, or diseased and similar livestock. (a) Livestock found to be dead or in a dying condition on the premises of...

  18. Discussion of death and dying in surgical textbooks.

    PubMed

    Easson, A M; Crosby, J A; Librach, S L

    2001-07-01

    Quality end-of-life care is an increasing concern for the public and the medical profession. Surgical textbooks could serve as an important educational and reference resource to improve this care. Four general surgical textbooks were scored for helpful information on death and dying for eight surgical diseases. For each disease, nine content domains related to care of the dying patient were evaluated. Three texts included a chapter on cancer that was evaluated separately. Disease epidemiology, prognosis/prevention, progression, and medical interventions were generally well discussed in all textbooks. However, little helpful information was provided with regards to breaking bad news/advanced care planning, mode of death, treatment decision-making, effect on family/surgeon, and symptom management. Cancer chapters also addressed only a few of these concerns. Death and the dying patient are sufficiently frequent in surgical practice that it would be appropriate to increase the amount of information provided.

  19. Investigating the Evolution of Progressive Die Wear on Uncoated Dp1180 Steel in Production Environment

    NASA Astrophysics Data System (ADS)

    Wu, W.; Zhou, D. J.; Adamski, D. J.; Young, D.; Wang, Y. W.

    2017-09-01

    A study of die wear was performed using an uncoated dual phase, 1,180 MPa ultimate tensile strength steel (DP1180) in a progressive die. The objectives of the current study are to evaluate the die durability of various tooling materials and coatings for forming operations on uncoated DP1180 steel and update OEM’s die standards based on the experimental results in the real production environment. In total, 100,800 hits were performed in manufacturing production conditions, where 33 die inserts with the combination of 10 die materials and 9 coatings were investigated. The die inserts were evaluated for surface wear using scanning electron microscopy and characterized in terms of die material and/or coating defects, failure mode, failure initiation and propagation. Surface roughness of the formed parts was characterized using a WYKO NT110 machine. The analytical analysis of the die inserts and formed parts, combined with the failure mode and service life, provide a basis for die material and coating selection for forming AHSS components. The conclusions of this study will guide the selection of die material and coatings for high-volume production of AHSS components.

  20. 3D FEM Geometry and Material Flow Optimization of Porthole-Die Extrusion

    NASA Astrophysics Data System (ADS)

    Ceretti, Elisabetta; Mazzoni, Luca; Giardini, Claudio

    2007-05-01

    The aim of this work is to design and to improve the geometry of a porthole-die for the production of aluminum components by means of 3D FEM simulations. In fact, the use of finite element models will allow to investigate the effects of the die geometry (webs, extrusion cavity) on the material flow and on the stresses acting on the die so to reduce the die wear and to improve the tool life. The software used to perform the simulations was a commercial FEM code, Deform 3D. The technological data introduced in the FE model have been furnished by METRA S.p.A. Company, partner in this research. The results obtained have been considered valid and helpful by the Company for building a new optimized extrusion porthole-die.

  1. Being One with the Universe: Finding a Silver Lining in Dying.

    PubMed

    Caratao-Mojica, Rhea

    2015-07-01

    Woody Allen once quoted, "I don't mind dying so much, I just don't want to be there when it happens" (as cited in Ingram, 2002, p. 1). Oftentimes, death is not a happy subject, a reality that most of us fear, yet something we all must face. In this paper, three articles were reviewed that explored the living-dying (Phillips, 1992) process of the terminally ill and the material was conceptualized in light of Rogers (1994) science of unitary human beings. To further understand and explore the living-dying process, creative examples (movie screenplay, novel, song and others) were cited. During the living-dying process exploration, three common themes were expressed by the subjects (dying persons), namely: valuing own perspective of quality of life; choosing personal meanings with ways of moving beyond with the possibles (Lee & Pilkington, 1999), while focusing on life's meaning rather than life's details (Dobratz, 2002); and connecting to the world-as-unknown while self-separating to the world-as-known in actively seeking the union with death (Kubler-Ross, 1981; Callanan & Kelly, 1992; Dobratz, 2002). It is important for healthcare providers to recognize and acknowledge all three themes to be able to understand dying persons, to focus on their wholeness rather than their disease, and to help families discern symbolic messages conveyed by them. Moreover, knowing these themes also enables healthcare providers to help all parties to transition and be able to accept and embrace the most difficult process—the living-dying (Phillips, 1992) process. © The Author(s) 2015.

  2. Measuring attitudes towards the dying process: A systematic review of tools.

    PubMed

    Groebe, Bernadette; Strupp, Julia; Eisenmann, Yvonne; Schmidt, Holger; Schlomann, Anna; Rietz, Christian; Voltz, Raymond

    2018-04-01

    At the end of life, anxious attitudes concerning the dying process are common in patients in Palliative Care. Measurement tools can identify vulnerabilities, resources and the need for subsequent treatment to relieve suffering and support well-being. To systematically review available tools measuring attitudes towards dying, their operationalization, the method of measurement and the methodological quality including generalizability to different contexts. Systematic review according to the PRISMA Statement. Methodological quality of tools assessed by standardized review criteria. MEDLINE, PsycINFO, PsyndexTests and the Health and Psychosocial Instruments were searched from their inception to April 2017. A total of 94 identified studies reported the development and/or validation of 44 tools. Of these, 37 were questionnaires and 7 alternative measurement methods (e.g. projective measures). In 34 of 37 questionnaires, the emotional evaluation (e.g. anxiety) towards dying is measured. Dying is operationalized in general items ( n = 20), in several specific aspects of dying ( n = 34) and as dying of others ( n = 14). Methodological quality of tools was reported inconsistently. Nine tools reported good internal consistency. Of 37 tools, 4 were validated in a clinical sample (e.g. terminal cancer; Huntington disease), indicating questionable generalizability to clinical contexts for most tools. Many tools exist to measure attitudes towards the dying process using different endpoints. This overview can serve as decision framework on which tool to apply in which contexts. For clinical application, only few tools were available. Further validation of existing tools and potential alternative methods in various populations is needed.

  3. Manufacture of gradient micro-structures of magnesium alloys using two stage extrusion dies

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hwang, Yeong-Maw; Huang, Tze-Hui; Alexandrov, Sergei

    2013-12-16

    This paper aims to manufacture magnesium alloy metals with gradient micro-structures using hot extrusion process. The extrusion die was designed to have a straight channel part combined with a conical part. Materials pushed through this specially-designed die generate a non-uniform velocity distribution at cross sections inside the die and result in different strain and strain rate distributions. Accordingly, a gradient microstructure product can be obtained. Using the finite element analysis, the forming temperature, effective strain, and effective strain rate distributions at the die exit were firstly discussed for various inclination angles in the conical die. Then, hot extrusion experiments withmore » a two stage die were conducted to obtain magnesium alloy products with gradient micro-structures. The effects of the inclination angle on the grain size distribution at cross sections of the products were also discussed. Using a die of an inclination angle of 15°, gradient micro-structures of the grain size decreasing gradually from 17 μm at the center to 4 μm at the edge of product were achieved.« less

  4. Results from a new die-to-database reticle inspection platform

    NASA Astrophysics Data System (ADS)

    Broadbent, William; Xiong, Yalin; Giusti, Michael; Walsh, Robert; Dayal, Aditya

    2007-03-01

    A new die-to-database high-resolution reticle defect inspection system has been developed for the 45nm logic node and extendable to the 32nm node (also the comparable memory nodes). These nodes will use predominantly 193nm immersion lithography although EUV may also be used. According to recent surveys, the predominant reticle types for the 45nm node are 6% simple tri-tone and COG. Other advanced reticle types may also be used for these nodes including: dark field alternating, Mask Enhancer, complex tri-tone, high transmission, CPL, EUV, etc. Finally, aggressive model based OPC will typically be used which will include many small structures such as jogs, serifs, and SRAF (sub-resolution assist features) with accompanying very small gaps between adjacent structures. The current generation of inspection systems is inadequate to meet these requirements. The architecture and performance of a new die-to-database inspection system is described. This new system is designed to inspect the aforementioned reticle types in die-to-database and die-to-die modes. Recent results from internal testing of the prototype systems are shown. The results include standard programmed defect test reticles and advanced 45nm and 32nm node reticles from industry sources. The results show high sensitivity and low false detections being achieved.

  5. Method of making cascaded die mountings with springs-loaded contact-bond options

    DOEpatents

    Hsu, John S [Oak Ridge, TN; Adams, Donald J [Knoxville, TN; Su, Gui-Jia [Knoxville, TN; Marlino, Laura D [Oak Ridge, TN; Ayers, Curtis W [Kingston, TN; Coomer, Chester [Knoxville, TN

    2007-06-19

    A cascaded die mounting device and method using spring contacts for die attachment, with or without metallic bonds between the contacts and the dies, is disclosed. One embodiment is for the direct refrigerant cooling of an inverter/converter carrying higher power levels than most of the low power circuits previously taught, and does not require using a heat sink.

  6. Prior suicide attempts are less common in suicide decedents who died by firearms relative to those who died by other means.

    PubMed

    Anestis, Michael D

    2016-01-01

    Suicide prevention efforts often center on the identification of risk factors (e.g., prior suicide attempts); however, lists of risk factors without consideration of context may prove incapable of impacting suicide rates. One contextual variable worth considering is attempt method. Utilizing data from the National Violent Death Reporting System (2005-2012), I examined suicide deaths (n=71,775) by firearms and other means to determine whether prior suicide attempts were more common in one group versus the other. Significantly fewer suicide decedents who died by firearms reported a prior history of suicide attempts (12.10%) than did decedents who died by other means (28.66%). This result was further replicated within each state that contributed data to the NVDRS. Only 17 states have contributed to the NVDRS thus far and, within those states, not all suicide deaths were reported. Due to the nature of the data, I was unable to test proposed mediators within our model. Suicide decedents who die by firearms may die on their first attempt more often than other decedents due to a capability and willingness to utilize a highly lethal means. Current risk assessment protocols may be ill equipped to identify such individuals prospectively on their own. Broader methods of implementing means restriction (e.g., legislation) may thus be pivotal in suicide prevention efforts. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Nurses' views on legalising assisted dying in New Zealand: A cross-sectional study.

    PubMed

    Wilson, Michael; Oliver, Pam; Malpas, Phillipa

    2018-04-15

    This study investigated New Zealand nurses' views on legalising assisted dying across a range of clinical conditions, nurses' willingness to engage in legal assisted dying, potential deterrents and enablers to such engagement, and nurses' perceptions of the proper role of their professional bodies in relation to legalising assisted dying. A Bill for legalising assisted dying is currently before the New Zealand parliament. Of the 16 jurisdictions where assisted dying has been specifically legislated, only the Canadian federal statute provides nurses with explicit legal protection for their performance of assisted dying-related tasks. An absence of policy development and planning for safe nursing practice prior to legalisation of assisted dying results in a gap in professional support and guidance. Exploratory cross-sectional survey. A self-selected sample of 475 New Zealand nurses responded to an anonymous online survey disseminated through the newsletters and websites of relevant medical and nursing professional bodies. A sub-sample of nurses who expressed support for or ambivalence about legalisation (n = 356): rated their level of support for legalising assisted dying in New Zealand across a range of medical conditions, and their willingness to participate in a range of assisted dying tasks; identified barriers and facilitators to potential participation; and assessed the responsibility of the professional bodies to provide practice supports. Mixed-method approach using descriptive analysis of quantitative data; qualitative data were analysed thematically. Nurses supported legalisation at a rate (67%) significantly greater than that of doctors (37%) and for a diverse range of medical conditions. Most supporting nurses were willing to engage in the full range of relevant assisted dying roles. They identified several practical and ethical supports as essential to safe engagement, in particular practice guidelines, specific training, legal protections, clinical

  8. Dying in the Hospital: Perspectives of family members.

    PubMed

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

    2015-01-01

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

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

    PubMed

    Abdel-Hamid, Sameh; Betz, Gabriele

    2011-04-01

    In tablet manufacturing, less attention is paid to the measurement of die-wall pressure than to force-displacement diagrams. Therefore, the aim of this study was to investigate radial stress change during pharmaceutical compaction. The Presster(TM), a tablet-press replicator, was used to characterize compaction behavior of microcrystalline cellulose (viscoelastic), calcium hydrogen phosphate dihydrate (brittle), direct compressible mannitol (plastic), pre-gelatinized starch (plastic/elastic), and spray dried lactose monohydrate (plastic/brittle) by measuring radial die-wall pressure; therefore powders were compacted at different (pre) compaction pressures as well as different speeds. Residual die-wall pressure (RDP) and maximum die-wall pressure (MDP) were measured. Various tablet physical properties were correlated to radial die-wall pressure. With increasing compaction pressure, RDP and MDP (P < 0.0001) increased for all materials, with increasing precompaction RDP decreased for plastic materials (P < 0.05), whereas with increasing speed MDP decreased for all materials (P < 0.05). During decompression, microcrystalline cellulose and pre-gelatinized starch showed higher axial relaxation, whereas mannitol and lactose showed higher radial relaxation, calcium hydrogen phosphate showed high axial and radial relaxations. Plastic and brittle materials showed increased tendencies for friction because of high radial relaxation. Die-wall monitoring is suggested as a valuable tool for characterizing compaction behavior of materials and detecting friction phenomena in the early stage of development.

  10. Nurses attitudes towards death, dying patients and euthanasia: A descriptive study.

    PubMed

    Ay, Melike Ayça; Öz, Fatma

    2018-01-01

    Attitudes of nurses towards death and related concepts influence end-of-life care. Determining nurses' views and attitudes towards these concepts and the factors that affect them are necessary to ensure quality end-of-life care. The purpose of this study was to determine nurses' views and attitudes about death, dying patient, euthanasia and the relationships between nurses' characteristics. Participants consist of the nurses who volunteered to take part in this descriptive study from 25 hospitals (n = 340) which has a paediatric or adult intensive care unit and located within the boundaries of Ankara, Turkey. 'Nurse Information Form' and 'Attitude Scale about Euthanasia, Death and Dying Patients (DAS)' were used as data collection tool. Ethical consideration: Written permissions were received from the 'Noninterventional Clinical Researches Ethics Board' of authors' university and education councils of each hospital. Informed consent was obtained from participants. It is found that there are statistically significant difference among the factors of marital status, having a child, years of experience, bereavement experience, affected by working with dying patient, definition of euthanasia, views about patients who are appropriate for euthanasia, views about patients who desire to die and feeling need for counselling on these concepts according to the mean total score of nurses' attitudes about euthanasia, death and dying patient (p < 0.05). The results indicate that nurses are negatively affected to face the concepts of death, euthanasia and work with dying patient. This is reflected in their attitude. In order to gain positive attitude towards death, dying patient and euthanasia, the implementation of training and consulting services to nurses at appropriate intervals during both education and professional life are required.

  11. Facilitating Attachment between School-Aged Children and a Dying Parent

    ERIC Educational Resources Information Center

    Saldinger, Amy; Cain, Albert C.; Porterfield, Katherine; Lohnes, Kelly

    2004-01-01

    A qualitative, community study of 58 parentally bereaved children and their 35 surviving parents illustrates how families take advantage of forewarning of death to foster connections between children and dying parents and prepare for youngsters' continued attachment to dying parents after the death. Children and parents displayed strong yearnings…

  12. High moisture corn stover pelleting in a flat die pellet mill fitted with a 6 mm die: physical properties and specific energy consumption

    DOE PAGES

    Tumuluru, Jaya Shankar

    2015-06-15

    The quality and specific energy consumption (SEC) of the biomass pellets produced depend upon pelleting process conditions. The present study includes understanding the effect of feedstock moisture in the range of 28–38% (wet basis [w.b.]) and preheating in the range of 30–110°C at two die speeds of 40 and 60 Hz on the physical properties and SEC. A flat die pellet mill fitted with a 6 mm die was used in the present study. The physical properties of pellets such as moisture content, unit, bulk and tapped density, durability, and expansion ratio and SEC of the pelleting process are measured.more » The results indicate that the pellets produced have durability values in the range of 87–98%, and unit bulk and tapped density in the range of 670–1100, 375–575, and 420–620 kg/m³. Increasing the feedstock moisture content from 33% to 38% (w.b) decreased the unit, bulk and tapped density by about 30–40%. Increasing feedstock moisture content increased the expansion ratio and decreased the density values. A higher feedstock moisture content of 38% (w.b.) and higher preheating temperature of 110°C resulted in lower density and a higher expansion ratio, which can be attributed to flash off of moisture as the material extrudes out of the die. The SEC was in the range of 75–275 kWh/ton. Higher feedstock moisture content of 38% (w.b.) and a lower die speed of 40 Hz increased the SEC, whereas lower to medium preheating temperature (30–70°C), medium feedstock moisture content of 33% (w.b.), and a higher die speed of 60 Hz minimized the SEC to <100 kWh/ton.« less

  13. Understandings of death and dying for people of Chinese origin.

    PubMed

    Hsu, Chiung-yin; O'Connor, Margaret; Lee, Susan

    2009-02-01

    This article introduces the primary beliefs about ancestor worship, Taoism, Confucianism, Buddhism and traditional Chinese medicine that have influenced Chinese people for thousands of years, particularly in relation to death and dying. These cultures and traditions remain important for Chinese people wherever they live. Over a long period, Chinese people have integrated these philosophies and religions to form the basis of their culture and traditions. Although they agree that death is a natural part of the life span, a unique belief about death and dying has emerged among the Chinese from this integration. From this, the people find a significant definition of death and dying.

  14. Death and Dying Anxiety among Bereaved and Nonbereaved Elderly Parents

    ERIC Educational Resources Information Center

    Azaiza, Faisal; Ron, Pnina; Shoham, Meyrav; Tinsky-Roimi, Tal

    2011-01-01

    This study examines differences in death and dying anxiety between bereaved and nonbereaved elderly Israeli parents, as well as correlates of these factors among bereaved parents. A total of 97 parents (49 bereaved, 48 nonbereaved) completed measures of death and dying anxiety and religiosity. Bereaved parents reported significantly higher dying…

  15. Teaching about Dying and Death in a Multidisciplinary Student Group.

    ERIC Educational Resources Information Center

    Barton, David; And Others

    1979-01-01

    Discusses dimensions which emerged in a multidisciplinary class of medical, nursing, social work, and theology students about dying and death. Group process was the most important aspect. Students evaluated their roles and transactions in caring for the dying. The recognition of solidarity of purpose, shared feeling, and mutual support emerged.…

  16. Three-Dimensional Computed Tomography as a Method for Finding Die Attach Voids in Diodes

    NASA Technical Reports Server (NTRS)

    Brahm, E. N.; Rolin, T. D.

    2010-01-01

    NASA analyzes electrical, electronic, and electromechanical (EEE) parts used in space vehicles to understand failure modes of these components. The diode is an EEE part critical to NASA missions that can fail due to excessive voiding in the die attach. Metallography, one established method for studying the die attach, is a time-intensive, destructive, and equivocal process whereby mechanical grinding of the diodes is performed to reveal voiding in the die attach. Problems such as die attach pull-out tend to complicate results and can lead to erroneous conclusions. The objective of this study is to determine if three-dimensional computed tomography (3DCT), a nondestructive technique, is a viable alternative to metallography for detecting die attach voiding. The die attach voiding in two- dimensional planes created from 3DCT scans was compared to several physical cross sections of the same diode to determine if the 3DCT scan accurately recreates die attach volumetric variability

  17. 9 CFR 381.194 - Transportation and other transactions concerning dead, dying, disabled, or diseased poultry, and...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... concerning dead, dying, disabled, or diseased poultry, and parts of carcasses of poultry that died otherwise... transactions concerning dead, dying, disabled, or diseased poultry, and parts of carcasses of poultry that died... commerce, or importing any dead, dying, disabled, or diseased poultry or parts of the carcasses of any...

  18. 9 CFR 381.194 - Transportation and other transactions concerning dead, dying, disabled, or diseased poultry, and...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... concerning dead, dying, disabled, or diseased poultry, and parts of carcasses of poultry that died otherwise... transactions concerning dead, dying, disabled, or diseased poultry, and parts of carcasses of poultry that died... commerce, or importing any dead, dying, disabled, or diseased poultry or parts of the carcasses of any...

  19. 9 CFR 381.194 - Transportation and other transactions concerning dead, dying, disabled, or diseased poultry, and...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... concerning dead, dying, disabled, or diseased poultry, and parts of carcasses of poultry that died otherwise... transactions concerning dead, dying, disabled, or diseased poultry, and parts of carcasses of poultry that died... commerce, or importing any dead, dying, disabled, or diseased poultry or parts of the carcasses of any...

  20. 9 CFR 381.194 - Transportation and other transactions concerning dead, dying, disabled, or diseased poultry, and...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... concerning dead, dying, disabled, or diseased poultry, and parts of carcasses of poultry that died otherwise... transactions concerning dead, dying, disabled, or diseased poultry, and parts of carcasses of poultry that died... commerce, or importing any dead, dying, disabled, or diseased poultry or parts of the carcasses of any...

  1. 9 CFR 381.194 - Transportation and other transactions concerning dead, dying, disabled, or diseased poultry, and...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... concerning dead, dying, disabled, or diseased poultry, and parts of carcasses of poultry that died otherwise... transactions concerning dead, dying, disabled, or diseased poultry, and parts of carcasses of poultry that died... commerce, or importing any dead, dying, disabled, or diseased poultry or parts of the carcasses of any...

  2. The quality of dying and death measurement instruments: A systematic psychometric review.

    PubMed

    Gutiérrez Sánchez, Daniel; Pérez Cruzado, David; Cuesta-Vargas, Antonio I

    2018-04-19

    To identify instruments that could assess the quality of dying and death and their psychometric properties. To assess the methodological quality of studies on measurement properties. A high quality of death is regarded as a goal at the end of life and, therefore, an assessment of the end of life experience is essential. Many instruments have been developed to evaluate the quality of dying and death. The selection of the most appropriate measure to be used in clinical and research settings is crucial. Psychometric systematic review. We systematically searched ProQuest Medline, SciELO and ProQuest PsycINFO from 1970 - May 2016. Identification and evaluation of instruments that assessed quality of dying and death. Papers were evaluated by two independent reviewers according to the COSMIN checklist with a 4-point scale. A total of 19 studies were included in this review. Seven instruments were found that were specifically designed for assessing quality of dying and death. A retrospective carer proxy report to evaluate this construct was used in most of the papers. The methodological quality of the studies was fair for most of the psychometric characteristics analyzed. Many instruments have been developed to assess the quality of dying and death. The Quality of Dying and Death Questionnaire is the best available measure of the quality of dying and death. It is the only questionnaire identified in this review where all psychometric properties according to the COSMIN checklist have been evaluated. © 2018 John Wiley & Sons Ltd.

  3. Hubble View of a Dying Star

    NASA Image and Video Library

    2003-05-21

    This image of a dying star, protoplanetary nebula IRAS22036+5306, containing strange, complex structures may help explain the death throes of stars and defy our current understanding of physics. Taken by NASA Wide Field and Planetary Camera 2.

  4. 9 CFR 325.20 - Transportation and other transactions concerning dead, dying, disabled, or diseased livestock...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... concerning dead, dying, disabled, or diseased livestock, and parts of carcasses of livestock that died... other transactions concerning dead, dying, disabled, or diseased livestock, and parts of carcasses of... transporting in commerce, or importing any dead, dying, disabled or diseased animals or parts of the carcasses...

  5. 9 CFR 325.20 - Transportation and other transactions concerning dead, dying, disabled, or diseased livestock...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... concerning dead, dying, disabled, or diseased livestock, and parts of carcasses of livestock that died... other transactions concerning dead, dying, disabled, or diseased livestock, and parts of carcasses of... transporting in commerce, or importing any dead, dying, disabled or diseased animals or parts of the carcasses...

  6. 9 CFR 325.20 - Transportation and other transactions concerning dead, dying, disabled, or diseased livestock...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... concerning dead, dying, disabled, or diseased livestock, and parts of carcasses of livestock that died... other transactions concerning dead, dying, disabled, or diseased livestock, and parts of carcasses of... transporting in commerce, or importing any dead, dying, disabled or diseased animals or parts of the carcasses...

  7. 9 CFR 325.20 - Transportation and other transactions concerning dead, dying, disabled, or diseased livestock...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... concerning dead, dying, disabled, or diseased livestock, and parts of carcasses of livestock that died... other transactions concerning dead, dying, disabled, or diseased livestock, and parts of carcasses of... transporting in commerce, or importing any dead, dying, disabled or diseased animals or parts of the carcasses...

  8. 9 CFR 325.20 - Transportation and other transactions concerning dead, dying, disabled, or diseased livestock...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... concerning dead, dying, disabled, or diseased livestock, and parts of carcasses of livestock that died... other transactions concerning dead, dying, disabled, or diseased livestock, and parts of carcasses of... transporting in commerce, or importing any dead, dying, disabled or diseased animals or parts of the carcasses...

  9. Communication About Dying, Death, and Bereavement: A Systematic Review of Children's Literature

    PubMed Central

    Arruda-Colli, Marina N. F.; Weaver, Meaghann S.

    2017-01-01

    Abstract Background: Children's books have the potential to facilitate communication about death for children living with a serious illness and for children coping with the death of a loved one. Objectives: This study examines the content of children's literature relevant to the topic of dying and death and identifies books providers can share with children and their families. Design: A search of children's literature was conducted using four electronic databases and one additional search engine using the word “Death” or “Dying.” Storybooks about dying, death, and bereavement published in English, French, or Spanish between 1995 and 2015 were included. Measurements: Each book underwent content analysis by at least two independent reviewers. Strict PRISMA standard was followed. Full protocol is available as PROSPERO #CRD42016042129. Results: Two hundred ten books met inclusion criteria. The dying subject was primarily a grandparent (n = 78) or pet (n = 44). Books on the experience of a child dying were scarce (n = 5). The word death or dying was used in 75% of the books (n = 158), while others utilized euphemisms. The majority of books featured animals (n = 40) or Caucasian subjects (n = 122) and included spiritual elements such as heaven (n = 122). Less than one-quarter of the books included tools for readers to address the topic of death. Conclusions: Storybooks can be a helpful tool to introduce communication about dying and death with children. Gaps exist in current children's literature to effectively enable children to reflect on their own dying process. A general summary of available books is provided to assist those caring for children and families facing end-of-life issues. PMID:28346862

  10. Energy Saving Melting and Revert Reduction Technology (E-SMARRT): Mechanical Performance of Dies

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    R. Allen Miller, Principal Investigator; Kabiri-Bamoradian, Contributors: Khalil; Delgado-Garza, Abelardo

    2011-09-13

    As a net shape process, die casting is intrinsically efficient and improvements in energy efficiency are strongly dependent on design and process improvements that reduce scrap rates so that more of the total consumed energy goes into acceptable, usable castings. A casting that is distorted and fails to meet specified dimensional requirements is typically remelted but this still results in a decrease in process yield, lost productivity, and increased energy consumption. This work focuses on developing, and expanding the use of, computer modeling methods that can be used to improve the dimensional accuracy of die castings and produce die designsmore » and machine/die setups that reduce rejection rates due to dimensional issues. A major factor contributing to the dimensional inaccuracy of the casting is the elastic deformations of the die cavity caused by the thermo mechanical loads the dies are subjected to during normal operation. Although thermal and die cavity filling simulation are widely used in the industry, structural modeling of the die, particularly for managing part distortion, is not yet widely practiced. This may be due in part to the need to have a thorough understanding of the physical phenomenon involved in die distortion and the mathematical theory employed in the numerical models to efficiently model the die distortion phenomenon. Therefore, two of the goals of this work are to assist in efforts to expand the use of structural modeling and related technologies in the die casting industry by 1) providing a detailed modeling guideline and tutorial for those interested in developing the necessary skills and capability and 2) by developing simple meta-models that capture the results and experience gained from several years of die distortion research and can be used to predict key distortion phenomena of relevance to a die caster with a minimum of background and without the need for simulations. These objectives were met. A detailed modeling tutorial

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

    PubMed

    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.

  12. Death and Dying Anxiety among Elderly Arab Muslims in Israel

    ERIC Educational Resources Information Center

    Azaiza, Faisal; Ron, Pnina; Shoham, Meyrav; Gigini, Ibrahim

    2010-01-01

    Death and dying anxiety were examined among elderly Arab Muslims in Israel. A total of 145 people aged 60 and over were interviewed using a standardized questionnaire. Nursing home residents reported higher death anxiety than others; women and uneducated participants reported greater levels of fear of death and dying than others. There were no…

  13. The Myriad Strategies for Seeking Control in the Dying Process

    ERIC Educational Resources Information Center

    Schroepfer, Tracy A.; Noh, Hyunjin; Kavanaugh, Melinda

    2009-01-01

    Purpose: This study explored the role control plays in the dying process of terminally ill elders by investigating the aspects of the dying process over which they seek to exercise control, the strategies they use, and whether they desire to exercise more control. Design and Methods: In-depth face-to-face interviews were conducted with 84…

  14. Smartes System für die Energiewende - der Übertragungsnetzbetreiber in der digitalen Zukunft

    NASA Astrophysics Data System (ADS)

    Pflaum, Rainer; Egeler, Tobias

    Die Übertragungsnetze stellen eine zuverlässige Versorgung von Haushalt, Gewerbe und Industrie mit elektrischer Energie sicher und sind damit Grundlage einer modernen Wirtschaft und Gesellschaft. Die mittlerweile unumkehrbaren Entwicklungen der nationalen und europäischen Energiewende stellen den Übertragungsnetzbetreiber in seinen Kernaufgaben, dem Bau und Betrieb von Netzen, dem Markt- und Netzzugang und der Integration der erneuerbaren Energien vor neue und große Herausforderungen. Verbrauchsnahe dezentrale Erzeugung wie verbrauchsferne zentrale Erzeugung muss im Sinne der Gewährleistung der Systemstabilität gemanagt und in Einklang mit dem Verbrauch gebracht werden. Erneuerbare Energien müssen zudem in einem solchen System ihren Beitrag zur System- und Marktintegration leisten. All das erfordert mehr Daten, um in einem Gesamtsystem dynamische Reaktionsmöglichkeiten gewährleisten zu können. Erst die "Digitalisierung" schafft dabei die notwendigen Voraussetzungen die Komplexität zu stemmen. Die Digitalisierung stellt daher ein Kernelement dieses Wandels des Übertragungsnetzbetreibers dar, die einerseits mit zum Entstehen der neuen Herausforderungen beiträgt, andererseits aber auch hilft Werkzeuge bereitzustellen, diesen Herausforderungen zu begegnen. Im folgenden Beitrag wird aufgezeigt, wie die Digitalisierung die Aufgaben und Instrumente des Übertragungsnetzbetreibers verändern. Ausgehend von den heutigen Aufgaben eines Übertragungsnetzbetreibers und dem gültigen Rechtsrahmen werden unter dem Begriff "Notwendiges Set für morgen" smarte Elemente und Werkzeuge beschrieben, die bereits heute im Einsatz sind oder in den nächsten Jahren notwendig werden. Im Anschluss erfolgt anhand einiger Beispiele aus unterschiedlichen Bereichen eine Konkretisierung der Einsatzzwecke der Digitalisierung beim Übertragungsnetzbetreiber. Ein kurzer Ausblick mit Fokus auf den weiteren Veränderungsprozess rundet den Beitrag ab.

  15. Die Deutsche Statistische Gesellschaft in der Weimarer Republik und während der Nazidiktatur

    NASA Astrophysics Data System (ADS)

    Wilke, Jürgen

    Nach anfänglichen Schwierigkeiten durch den 1. Weltkrieg erlangte die Deutsche Statistische Gesellschaft (DStatG) unter dem renommierten Statistiker und Vorsitzenden der DStatG, Friedrich Zahn, durch eine Vielzahl von Aktivitäten hohes Ansehen. Es gab Bestrebungen, Statistiker aus allen Arbeitsfeldern der Statistik in die DStatG zu integrieren, wobei die "Mathematische Statistik" nur zögerlich akzeptiert wurde (Konjunkturforschung, Zeitreihenanalyse). Nach der Machtübernahme 1933 durch Adolf Hitler geriet die DStatG in das Fahrwasser nationalsozialistischer Ideologie und Politik (Führerprinzip, Gleichschaltung des Vereinswesens). Damit war eine personelle Umstrukturierung in der DStatG verbunden. Politisch Missliebige und rassisch Verfolgte mussten die DStatG verlassen (Bernstein, Freudenberg, Gumbel u.a.). Unter den Statistikern gab es alle Abstufungen im Verhalten zum Regime von Ablehnung und zwangsweiser Anpassung über bereitwilliges Mitläufertum bis zu bewusster Täterschaft. Besonders die Bevölkerungsstatistik wurde durch die NS- Rassenpolitik auf lange Sicht diskreditiert. Im Rahmen von Wirtschaftsplanung und Aufrüstung wurden neue zukunftsträchtige statistische Modelle (Grünig, Bramstedt, Leisse) entwickelt.

  16. Study the effect of elevated dies temperature on aluminium and steel round deep drawing

    NASA Astrophysics Data System (ADS)

    Lean, Yeong Wei; Azuddin, M.

    2016-02-01

    Round deep drawing operation can only be realized by expensive multi-step production processes. To reduce the cost of processes while expecting an acceptable result, round deep drawing can be done at elevated temperature. There are 3 common problems which are fracture, wrinkling and earing of deep drawing a round cup. The main objective is to investigate the effect of dies temperature on aluminium and steel round deep drawing; with a sub-objective of eliminate fracture and reducing wrinkling effect. Experimental method is conducted with 3 different techniques on heating the die. The techniques are heating both upper and lower dies, heating only the upper dies, and heating only the lower dies. 4 different temperatures has been chosen throughout the experiment. The experimental result then will be compared with finite element analysis software. There is a positive result from steel material on heating both upper and lower dies, where the simulation result shows comparable as experimental result. Heating both upper and lower dies will be the best among 3 types of heating techniques.

  17. The Onion and "When Legends Die."

    ERIC Educational Resources Information Center

    Bell, Loren C.

    1984-01-01

    Describes the eight layers in Thomas Black Bull's ("When the Legends Die") journey to spiritual rebirth and stresses that students can easily identify these layers and can thereby achieve a clearer understanding of the relationship between structure and meaning in fiction. (CRH)

  18. Archaeometric study on minting dies produced under papal rule in Ferrara

    NASA Astrophysics Data System (ADS)

    Monticelli, Cecilia; Balbo, Andrea; Vaccaro, Carmela; Gulinelli, Maria Teresa; Garagnani, Gian Luca

    2013-12-01

    In the Civic Museum of Palazzo Schifanoia in Ferrara, a collection of 1104 coin striking tools is stored. Among these, eight steel dies produced from the 2nd decade of the seventeenth to the half of the eighteenth century, representative of the whole period of activity of the papal mint in Ferrara, have been chosen and studied. In that period, while important innovations in the coin minting technique were introduced in Europe, Ferrara declined from the rank of ducal mint to that of peripheral minting center of the highly centralized Papal States. The dies have been characterized by metallographic, chemical, and microhardness investigations. The results suggest that the dies were obtained by a manual smithing technique consisting in hammer hot forging. The die quality improved with time. In fact, in the period 1619-1622, a hardening treatment for the engraved die end consisting in a simple local carburization coexisted with a more efficient production method, based on the application of a proper final heat treatment. This treatment induced a graded microstructure from the engraved end, with a hard martensitic or bainitic structure, to the opposite end, with a tough ferritic/pearlitic structure. From 1675 onward, the latter production method was applied on all the studied dies. The chemical analysis of the alloys suggest that they were likely obtained from iron ores with a common provenance, while the analysis of the slag inclusions suggests the adoption of a direct method of ironmaking throughout the activity period of the mint.

  19. Dying cancer patients talk about euthanasia.

    PubMed

    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.

  20. Daughters caring for dying parents: a process of relinquishing.

    PubMed

    Read, Trudy; Wuest, Judith

    2007-09-01

    Caring for elderly, dying parents is challenging for daughters as they try to balance other obligations and responsibilities. The purpose of this grounded theory study was to explain the domain of daughters' caregiving experiences in Newfoundland and Labrador, Canada. The primary author interviewed 12 women whose parents had died. Three types of turmoil (emotional, relational, and societal) emerged as the central issue for these women. The authors discovered a substantive theory of Relinquishing with interdependent processes of Keeping Vigil, Navigating Systems, Facing Loss, and an end process of Coming to Terms. In moving through the process of Relinquishing, social conditions of personal ideals, family expectations, and societal demands determine strategies employed by any one daughter to manage her turmoil. The findings fill a gap in knowledge related to daughters' caregiving for dying parents by contributing a theoretical framework that will inform women, health care providers, researchers, and health policy makers.

  1. Agency behind bars: Advance care planning with aging and dying offenders.

    PubMed

    Sanders, Sara; Stensland, Meredith; Juraco, Kim

    2018-01-01

    Aging and terminally ill individuals in U.S. prisons are increasing, making critical the need for appropriate end-of-life (EOL) care and advance care planning (ACP). Applying Bandura's agentic perspective, the authors examined 20 aging/dying offenders' EOL preferences and ACP. Findings include 6 themes: decisions in the shadow of the past, what works best for me, feeling blessed, what is really going on, can anyone be trusted, and turning agency over to someone else. This study provides critical information that will assist professionals who work with dying offenders, as it presents a vivid illustration of their dying process.

  2. Design and Analysis of a Forging Die for Manufacturing of Multiple Connecting Rods

    NASA Astrophysics Data System (ADS)

    Megharaj, C. E.; Nagaraj, P. M.; Jeelan Pasha, K.

    2016-09-01

    This paper demonstrates to utilize the hammer capacity by modifying the die design such that forging hammer can manufacture more than one connecting rod in a given forging cycle time. To modify the die design study is carried out to understand the parameters that are required for forging die design. By considering these parameters, forging die is designed using design modelling tool solid edge. This new design now can produce two connecting rods in same capacity hammer. The new design is required to validate by verifying complete filing of metal in die cavities without any defects in it. To verify this, analysis tool DEFORM 3D is used in this project. Before start of validation process it is require to convert 3D generated models in to. STL file format to import the models into the analysis tool DEFORM 3D. After importing these designs they are analysed for material flow into the cavities and energy required to produce two connecting rods in new forging die design. It is found that the forging die design is proper without any defects and also energy graph shows that the forging energy required to produce two connecting rods is within the limit of that hammer capacity. Implementation of this project increases the production of connecting rods by 200% in less than previous cycle time.

  3. Robert Merton Dies at 92

    ERIC Educational Resources Information Center

    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…

  4. Dying and the Conspiracy of Denial

    ERIC Educational Resources Information Center

    Doherty, Gillian; Doherty, Joseph

    1976-01-01

    The first author presents her reviews on death based on her experiences as a nurse and a wife whose husband had a terminal illness. The second author presents a poem expressing his views on death while he was dying of a terminal illness. (HLM)

  5. Noncanonical autophagy inhibits the auto-inflammatory, lupus-like response to dying cells

    PubMed Central

    Martinez, Jennifer; Cunha, Larissa D.; Park, Sunmin; Yang, Mao; Lu, Qun; Orchard, Robert; Li, Quan-Zhen; Yan, Mei; Janke, Laura; Guy, Cliff; Linkermann, Andreas; Virgin, Herbert W.; Green, Douglas R.

    2016-01-01

    Defects in dying cell clearance are postulated to underlie the pathogenesis of systemic lupus erythematosus (SLE)1. Mice lacking molecules associated with dying cell clearance develop SLE-like disease2, and phagocytes from SLE patients often display defective clearance and increased inflammatory cytokine production when exposed to dying cells in vitro. Previously, we3–6 and others7 described a form of noncanonical autophagy called “LC3-associated phagocytosis” (LAP), wherein phagosomes containing engulfed particles, including dying cells3,4,7, recruit elements of the autophagy pathway to facilitate phagosome maturation and digestion of cargo. Genome-wide association studies have identified polymorphisms in atg58 and possibly atg79, involved in both canonical autophagy and LAP3–7, as predisposition markers for SLE. Here, we describe the consequences of defective LAP in vivo. Mice lacking any of several components of the LAP pathway display elevated serum inflammatory cytokines, autoantibodies, glomerular immune complex deposition, and evidence of kidney damage. Dying cells, injected into LAP-deficient animals, are engulfed but not efficiently degraded, and trigger acute elevation of pro-inflammatory cytokines but not the anti-inflammatory interleukin (IL)-10. Repeated injection of dying cells into LAP-deficient, but not LAP-sufficient animals accelerated SLE-like disease, including increased serum levels of autoantibodies. In contrast, animals deficient for genes required for canonical autophagy but not LAP do not display defective dead cell clearance, inflammatory cytokine production, or SLE-like disease, and like wild-type animals, produce IL-10 in response to dying cells. Therefore, defects in LAP, rather than canonical autophagy, can cause SLE-like phenomena, and may contribute to the pathogenesis of SLE. PMID:27096368

  6. Health Care Providers and Dying Patients: Critical Issues in Terminal Care.

    ERIC Educational Resources Information Center

    Benoliel, Jeanne Quint

    1988-01-01

    Identifies three major areas of concern in relationship between health care providers and dying patients: (1) nature of difficulties and stresses associated with terminal care; (2) education of providers for work; and (3) influence of organizational structure and institutionalized values on services for dying patients and families. Reviews…

  7. Removing function model and experiments on ultrasonic polishing molding die

    NASA Astrophysics Data System (ADS)

    Huang, Qitai; Ni, Ying; Yu, Jingchi

    2010-10-01

    Low temperature glass molding technology is the main method on volume-producing high precision middle and small diameter optical cells in the future. While the accuracy of the molding die will effect the cell precision, so the high precision molding die development is one of the most important part of the low temperature glass molding technology. The molding die is manufactured from high rigid and crisp metal alloy, with the ultrasonic vibration character of high vibration frequency and concentrative energy distribution; abrasive particles will impact the rigid metal alloy surface with very high speed that will remove the material from the work piece. Ultrasonic can make the rigid metal alloy molding die controllable polishing and reduce the roughness and surface error. Different from other ultrasonic fabrication method, untouched ultrasonic polishing is applied on polish the molding die, that means the tool does not touch the work piece in the process of polishing. The abrasive particles vibrate around the balance position with high speed and frequency under the drive of ultrasonic vibration in the liquid medium and impact the workspace surface, the energy of abrasive particles come from ultrasonic vibration, while not from the direct hammer blow of the tool. So a nummular vibrator simple harmonic vibrates on an infinity plane surface is considered as a model of ultrasonic polishing working condition. According to Huygens theory the sound field distribution on a plane surface is analyzed and calculated, the tool removing function is also deduced from this distribution. Then the simple point ultrasonic polishing experiment is proceeded to certificate the theory validity.

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

    PubMed

    Zimmermann, Camilla

    2012-07-01

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

  9. Fatigue of die cast zinc alloys

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Schrems, K.K.; Dogan, O.N.; Goodwin, F.E.

    2006-04-01

    The rotating bending fatigue limit of die cast zinc alloy 2, alloy 3, alloy 5, AcuZinc 5, and ZA-8 were determined as a part of an on-going program by ILZRO into the mechanical properties of die cast zinc. The stress-life (S-N) curves of alloys 3, 5, AcuZinc 5, and ZA-8 were determined previously. This presentation reports the results of the S-N curve for Alloy 2 and the calculated fatigue limits for all five alloys. During the previous stress-life testing, the samples were stopped at 10 million cycles and the fatigue limit for alloy 3, alloy 5, and AcuZinc 5 appearedmore » to be higher and the fatigue limit for ZA-8 appeared to be lower than the values reported in the literature. This was further investigated in alloy 5 and ZA-8 by testing continuous cast bulk alloy 5 and ZA-8.« less

  10. Die-target for dynamic powder consolidation

    DOEpatents

    Flinn, John E.; Korth, Gary E.

    1986-01-01

    A die/target is disclosed for consolidation of a powder, especially an atomized rapidly solidified metal powder, to produce monoliths by the dynamic action of a shock wave, especially a shock wave produced by the detonation of an explosive charge. The die/target comprises a rectangular metal block having a square primary surface with four rectangular mold cavities formed therein to receive the powder. The cavities are located away from the geometrical center of the primary surface and are distributed around such center while also being located away from the geometrical diagonals of the primary surface to reduce the action of reflected waves so as to avoid tensile cracking of the monoliths. The primary surface is covered by a powder retention plate which is engaged by a flyer plate to transmit the shock wave to the primary surface and the powder. Spawl plates are adhesively mounted on other surfaces of the block to act as momentum traps so as to reduce reflected waves in the block.

  11. Untersuchungen ueber die Kultivierung und Biologie von Trichomonas vaginalis (Investigation on Cultivation and Biology of Trichomonas vaginalis),

    DTIC Science & Technology

    Since long possible cyst formation by Trichomonas vaginalis has been discussed. According to our observations the round forms of Trichomonas ... vaginalis in relation to its biogenic surroundings. Here the biochemico-physiological relationship between Trichomonas and the fundamental biogenic...generally appear as degenerative manifestations of the cell, especially in older cultures. We tried to study analytically the biology of Trichomonas

  12. Assisted dying in liberalised jurisdictions and the role of psychiatry: a clinician's view.

    PubMed

    Macleod, Sandy

    2012-10-01

    Assisted dying is a contentious and topical issue. Mental disorder is a relevant influence on requests of hastened death. The psychiatry of dying is not a prominent component in the assessment of euthanasia and physician-assisted suicide (PAS) in jurisdictions with liberalised assisted dying laws. The literature on the assessment processes, with particular reference to mental status, involved in euthanasia requests is considered. An experienced palliative medicine specialist and psychiatrist selectively reviewed the recent literature published about the mental health issues involved in euthanasia and PAS. Assessments of competency, sustained wish to die prematurely, depressive disorder, demoralisation and 'unbearable suffering' in the terminally ill are clinically uncertain and difficult tasks. There is a growing psychiatric and psychological literature on the mental status of the terminally ill. As yet psychiatry does not have the expertise to 'select' those whose wish for hastened death is rational, humane and 'healthy'. Rarely in those societies with liberalised assisted dying laws are psychiatrists involved in the decision-making for individuals requesting early death. This role is fulfilled by non-specialists. There remain significant concerns about the accuracy of psychiatric assessment in the terminally ill. Mental processes are more relevant influences on a hastened wish to die than are the physical symptoms of terminal malignant disease. Psychiatric review of persons requesting euthanasia is relevant. It is not obligatory or emphasised in those legislations allowing assisted dying. Psychiatry needs to play a greater role in the assessment processes of euthanasia and PAS.

  13. Finite element design procedure for correcting the coining die profiles

    NASA Astrophysics Data System (ADS)

    Alexandrino, Paulo; Leitão, Paulo J.; Alves, Luis M.; Martins, Paulo A. F.

    2018-05-01

    This paper presents a new finite element based design procedure for correcting the coining die profiles in order to optimize the distribution of pressure and the alignment of the resultant vertical force at the end of the die stroke. The procedure avoids time consuming and costly try-outs, does not interfere with the creative process of the sculptors and extends the service life of the coining dies by significantly decreasing the applied pressure and bending moments. The numerical simulations were carried out in a computer program based on the finite element flow formulation that is currently being developed by the authors in collaboration with the Portuguese Mint. A new experimental procedure based on the stack compression test is also proposed for determining the stress-strain curve of the materials directly from the coin blanks.

  14. Why do we want the right to die? A systematic review of the international literature on the views of patients, carers and the public on assisted dying.

    PubMed

    Hendry, Maggie; Pasterfield, Diana; Lewis, Ruth; Carter, Ben; Hodgson, Daniel; Wilkinson, Clare

    2013-01-01

    Assisted dying is legal in four European countries and three American states. Elsewhere, particularly in more affluent or mainly Protestant countries, it remains controversial. Dominant headlines feature professional (medical, legal, religious) arguments versus celebrity campaigners; ordinary people are less clearly represented. To synthesise the international evidence of people's views and attitudes towards assisted dying in order to inform current debate about this controversial issue. Systematic review and mixed method synthesis of qualitative and survey data. Eleven electronic databases from inception to October 2011; bibliographies of included studies. Two reviewers independently screened papers and appraised quality. Qualitative results were extracted verbatim; survey results were summarised in a table. Qualitative data were synthesised using framework methods and survey results integrated where they supported, contrasted or added to the themes identified. Sixteen qualitative studies and 94 surveys were included; many participants considered the immediate relevance of assisted dying for them. Themes related to poor quality of life, a good quality of death, potential abuse of assisted dying and the importance of individual stance. People valued autonomy in death as much as in life. Attitudes were diverse, complex and related to definitions of unbearable suffering including physical, psycho-social and existential factors and were consistent regardless of social, economic, legal and health-care contexts. Our review sheds light on ordinary people's perspectives about assisted dying, when they are ill or disabled. Unbearable suffering is a key construct, and common factors are revealed that lead people to ask for help to die. The consistency of international views indicates a mandate for legislative and medical systems worldwide to listen and understand this.

  15. Death and Dying in Modern America

    ERIC Educational Resources Information Center

    Feifel, Herman

    1977-01-01

    Appreciation of finiteness, of our temporal character, can serve not only to enrich self-knowledge but also to provide the momentum to propel us forward toward productivity, achievement, and creativity. Presented at the Conference on Death and Dying: Education, Counseling, and Care, December 1-3, 1976, Orlando, Florida. (Author)

  16. Is the patient's right to die evolving into a duty to die?: Medical decision making and ethical evaluations in health care.

    PubMed

    Sprung, C L; Eidelman, L A; Steinberg, A

    1997-02-01

    When patient or family requests for continued life-sustaining treatments conflict with doctor recommendations, different conclusions as to what is beneficial for the patient may arise. Past practices usually accepted patient or family requests based on the principle of autonomy or that the doctor's primary responsibility is to the individual patient. Many patients die in intensive care units after doctors forego life-prolonging interventions. Health care changes and cost containment have led to a change in the classical ethical model of the patient-doctor relationship such that concerns for societal requirements increasingly overrule those for individual patient needs. The ability to keep patients alive with little likelihood of recovery and the recognition of escalating health costs have led to calls for the needs of society and distributive justice to be taken into account. A tendency to justify a duty to die for these patients has arisen. Recent legal decisions in cases with conflicts between families and health care providers and institutions over foregoing life-sustaining therapies have decided for the families against doctors and hospitals, compelling institutions and their staff to act contrary to their ethical views. Value judgments of doctors are sometimes confused with medical indications for therapy. Doctors have defined therapies as futile or non-beneficial based on their own values and even withdrawn life-sustaining treatments without patient or family input. In some cases, the right to die is leading to the duty to die even against patient or surrogate wishes. Such observations indicate the need for rigorous analyses of medical decision making in this context and for ethical evaluations in health care in general.

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

    ERIC Educational Resources Information Center

    Green, Joseph S.; And Others

    1978-01-01

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

  18. Quality of Dying in Nursing Home Residents Dying with Dementia: Does Advanced Care Planning Matter? A Nationwide Postmortem Study

    PubMed Central

    Vandervoort, An; Houttekier, Dirk; Vander Stichele, Robert; van der Steen, Jenny T.; Van den Block, Lieve

    2014-01-01

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

  19. To Die, To Sleep: A Contrastive Study of Metaphors for Death and Dying in English and Spanish.

    ERIC Educational Resources Information Center

    Marin-Arrese, Juana I.

    1996-01-01

    Contrasts the use of metaphors for death and dying in English and Spanish and makes some observations concerning universal and culture-specific conceptualizations. The article points out that the human capacity to conceptualize and reason derives from experience (perceptions, cultural practices, motor activity) and imagination (metaphor, metonymy,…

  20. Counseling Older Persons: Careers, Retirement, Dying.

    ERIC Educational Resources Information Center

    Sinick, Daniel

    The focus of this monograph is on three areas of counseling with older clients: career counseling, retirement counseling, and counseling regarding death and dying. The portion on career counseling includes reasons older persons change careers, obstacles they are likely to face when seeking employment, myths surrounding the employability of older…

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

    PubMed

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

    2016-03-01

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

  2. Modellierung des Einflusses der Landnutzung auf die Hochwasserentstehung in der Mesoskala

    NASA Astrophysics Data System (ADS)

    Niehoff, Daniel

    2001-10-01

    Seit 1990 waren mehrere der großen Flussgebiete Mitteleuropas wiederholt von extremen Hochwassern betroffen. Da sowohl die Landoberfläche als auch die Flusssysteme weiter Teile Mitteleuropas in der Vergangenheit weitreichenden Eingriffen ausgesetzt gewesen sind, wird bei der Suche nach den Ursachen für diese Häufung von Extremereignissen auch die Frage nach der Verantwortung des Menschen hierfür diskutiert. Gewässerausbau, Flächenversiegelung, intensive landwirtschaftliche Bodenbearbeitung, Flurbereinigung und Waldschäden sind nur einige Beispiele und Folgen der anthropogenen Eingriffe in die Landschaft. Aufgrund der Vielfalt der beteiligten Prozesse und deren Wechselwirkungen gibt es allerdings bislang nur Schätzungen darüber, wie sehr sich die Hochwassersituation hierdurch verändert hat. Vorrangiges Ziel dieser Arbeit ist es, mit Hilfe eines hydrologischen Modells systematisch darzustellen, in welcher Weise, in welcher Größenordnung und unter welchen Umständen die Art der Landnutzung auf die Hochwasserentstehung Einfluss nimmt. Dies wird anhand exemplarischer Modellanwendungen in der hydrologischen Mesoskala untersucht. Zu diesem Zweck wurde das deterministische und flächendifferenzierte hydrologische Modell wasim-eth ausgewählt, das sich durch eine ausgewogene Mischung aus physikalisch begründeten und konzeptionellen Ansätzen auszeichnet. Das Modell wurde im Rahmen dieser Arbeit um verschiedene Aspekte erweitert, die für die Charakterisierung des Einflusses der Landnutzung auf die Hochwasserentstehung wichtig sind: (1) Bevorzugtes Fließen in Makroporen wird durch eine Zweiteilung des Bodens in Makroporen und Bodenmatrix dargestellt, die schnelle Infiltration und Perkolation jenseits der hydraulischen Leitfähigkeit der Bodenmatrix ermöglicht. (2) Verschlämmung äußert sich im Modell abhängig von Niederschlagsintensität und Vegetationsbedeckungsgrad als Verschlechterung der Infiltrationsbedingungen an der Bodenoberfläche. (3) Das

  3. Energy Saving Melting and Revert Reduction Technology: Improved Die Casting Process to Preserve the Life of the Inserts

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    David Schwam, PI; Xuejun Zhu, Sr. Research Associate

    2012-09-30

    The goal of this project was to study the combined effects of die design, proper internal cooling and efficient die lubricants on die life. The project targeted improvements in die casting insert life by: Optomized Die Design for Reduced Surface Temperature: The life of die casting dies is significantly shorter when the die is exposed to elevated temperature for significant periods of time. Any die operated under conditions leading to surface temperature in excess of 1050oF undergoes structural changes that reduce its strength. Optimized die design can improve die life significantly. This improvement can be accomplished by means of coolingmore » lines, baffles and bubblers in the die. A key objective of the project was to establish criteria for the minimal distance of the cooling lines from the surface. This effort was supported with alloys and machining by BohlerUddeholm, Dunn Steel, HH Stark and Rex Buckeye. In plant testing and evaluation was conducted as in-kind cost share at St. Clair Die Casting. The Uddeholm Dievar steel evaluated in this program showed superior resistance to thermal fatigue resistance. Based on the experimental evidence, cooling lines could be placed as close as 0.5" from the surface. Die Life Extension by Optimized Die Lubrication: The life of die casting dies is affected by additions made to its surface with the proper lubricants. These lubricants will protect the surface from the considerable temperature peaks that occur when the molten melt enters the die. Dies will reach a significantly higher temperature without this lubricant being applied. The amount and type of the lubricant are critical variables in the die casting process. However, these lubricants must not corrode the die surface. This effort was supported with alloys and machining by BohlerUddeholm, Dunn Steel, HH Stark and Rex Buckeye. In plant testing and evaluation was conducted as in-kind cost share at St. Clair Die Casting. Chem- Trend participated in the program

  4. Attitudes and experiences of nurses toward death and caring for dying patients in Turkey.

    PubMed

    Cevik, Banu; Kav, Sultan

    2013-01-01

    Caring of the dying patients and facing the death can be a stressful and difficult experience for nurses. Besides personal and professional experiences, nurses' own attitudes toward death may affect the care given to dying individuals. The aim of this study was to examine Turkish nurses' attitudes toward and experiences with death and caring for dying patients. A descriptive, cross-sectional study was conducted at 2 university hospitals and 1 state hospital located in Ankara, Turkey. Data were collected via sociodemographics form, the Death Attitude Profile-Revised, and Frommelt's Attitude Toward Caring for Dying Patients. The attitudes of Turkish nurses toward death and caring for dying patients are less positive than the reported attitudes of nurses in other studies. Significant relationships were found among level of education, willingness to care for dying patients, and scores on Frommelt's Attitude Toward Caring for Dying Patients and on Death Attitude Profile-Revised subscales (P < .05). Although the majority of nurses (85%) stated that they had received education on end of life, most of them (82%) were not comfortable talking about death. A lack of education and experience may contribute to the negative attitudes. Providing a reflective narrative environment in which nurses can express their personal feelings about death and dying could be a potentially effective approach. This study highlights the need for further educational research and development of better educational programs to help nurses to explore and understand their attitudes toward death, overcome fears, increase communication skills, and enhance coping strategies.

  5. Influence of the supporting die structures on the fracture strength of all-ceramic materials.

    PubMed

    Yucel, Munir Tolga; Yondem, Isa; Aykent, Filiz; Eraslan, Oğuz

    2012-08-01

    This study investigated the influence of the elastic modulus of supporting dies on the fracture strengths of all-ceramic materials used in dental crowns. Four different types of supporting die materials (dentin, epoxy resin, brass, and stainless steel) (24 per group) were prepared using a milling machine to simulate a mandibular molar all-ceramic core preparation. A total number of 96 zirconia cores were fabricated using a CAD/CAM system. The specimens were divided into two groups. In the first group, cores were cemented to substructures using a dual-cure resin cement. In the second group, cores were not cemented to the supporting dies. The specimens were loaded using a universal testing machine at a crosshead speed of 0.5 mm/min until fracture occurred. Data were statistically analyzed using two-way analysis of variance and Tukey HSD tests (α = 0.05). The geometric models of cores and supporting die materials were developed using finite element method to obtain the stress distribution of the forces. Cemented groups showed statistically higher fracture strength values than non-cemented groups. While ceramic cores on stainless steel dies showed the highest fracture strength values, ceramic cores on dentin dies showed the lowest fracture strength values among the groups. The elastic modulus of the supporting die structure is a significant factor in determining the fracture resistance of all-ceramic crowns. Using supporting die structures that have a low elastic modulus may be suitable for fracture strength tests, in order to accurately reflect clinical conditions.

  6. The contribution of a MOOC to community discussions around death and dying.

    PubMed

    Tieman, Jennifer; Miller-Lewis, Lauren; Rawlings, Deb; Parker, Deborah; Sanderson, Christine

    2018-02-20

    Advances in medicine have helped many to live longer lives and to be able to meet health challenges. However death rates are anticipated to increase given the ageing population and chronic disease progression. Being able to talk about death is seen to be important in normalising death as part of life and supporting preparedness for death. Massive Open Online Courses (MOOCs) provide opportunities for the community to engage in collaborative learning. A 5 week MOOC was developed covering four main topics (language and humour, representations of death, medicalisation of dying, and digital dying) aiming: To enable participants to openly and supportively discuss and learn about issues around living, death and dying, To explore the normally unheard opinions and views of Australians around death and dying, and To determine what effect online learning and discussions offered through the MOOC had on participants' feelings and attitudes towards death and dying. Data was captured on engagement rates in the various MOOC activities. Death Attitudes were measured by five items representing the MOOC's learning objectives and completed at enrolment and conclusion. MOOC Satisfaction was measured with six items at the end of the MOOC. Descriptive statistics were produced for each variable and Chi-Square Tests of Independence assessed the extent of the relationship between categorical variables. Socio-demographic variables were examined as predictors of the outcome variables of MOOC engagement, MOOC satisfaction, and death attitudes. Ethical approval was received from Flinders University Social and Behavioural Research Ethics Committee (Project No. 7247). One thousand one hundred fifty six people enrolled in the Dying2Learn MOOC with 895 participating in some way. Enrolees were primarily female (92.1%). Age ranged from 16 to 84 (mean = 49.5, SD = 12.3). MOOC satisfaction scores were high. Responses to the experience of participating in the MOOC were very positive, with mean

  7. Self-Determination, the Right to Die, and Culture: A Literature Review

    ERIC Educational Resources Information Center

    McCormick, Andrew J.

    2011-01-01

    Self-determination is a primary ethical principle underlying social work practice in health care settings. Since the 1970s, a right-to-die movement that shares the social work commitment to self-determination has grown and influences end-of-life care decisions. However, the role of culture is notably absent in discussions of the right to die. A…

  8. Stamping Die Making. 439-318/320.

    ERIC Educational Resources Information Center

    Yunke, P.; And Others

    Each unit in this curriculum guide on stamping die making contains an introduction, objectives, materials required, lessons, space for notes, figures, and diagrams. There are 29 units in this guide, dealing with the following topics: EZ-MILL programming; EZ-MILL BATT; print of punch and EZ-MILL part programming; download to Computer Numerical…

  9. Constructing Death: Three Pathographies about Dying.

    ERIC Educational Resources Information Center

    Hawkins, Anne Hunsaker

    1991-01-01

    Discusses three pathographies as models for the "good death." In each, the author organizes the phenomena associated with the illness and death of a spouse from cancer into a coherent pattern. The result is three different paradigms of the experience of dying: "ritual death,""victorious death," and "one's own death." (Author/LLL)

  10. Development of materials for the rapid manufacture of die cast tooling

    NASA Astrophysics Data System (ADS)

    Hardro, Peter Jason

    The focus of this research is to develop a material composition that can be processed by rapid prototyping (RP) in order to produce tooling for the die casting process. Where these rapidly produced tools will be superior to traditional tooling production methods by offering one or more of the following advantages: reduced tooling cost, shortened tooling creation time, reduced man-hours for tool creation, increased tool life, and shortened die casting cycle time. By utilizing RP's additive build process and vast material selection, there was a prospect that die cast tooling may be produced quicker and with superior material properties. To this end, the material properties that influence die life and cycle time were determined, and a list of materials that fulfill these "optimal" properties were highlighted. Physical testing was conducted in order to grade the processability of each of the material systems and to optimize the manufacturing process for the downselected material system. Sample specimens were produced and microscopy techniques were utilized to determine a number of physical properties of the material system. Additionally, a benchmark geometry was selected and die casting dies were produced from traditional tool materials (H13 steel) and techniques (machining) and from the newly developed materials and RP techniques (selective laser sintering (SLS) and laser engineered net shaping (LENS)). Once the tools were created, a die cast alloy was selected and a preset number of parts were shot into each tool. During tool creation, the manufacturing time and cost was closely monitored and an economic model was developed to compare traditional tooling to RP tooling. This model allows one to determine, in the early design stages, when it is advantageous to implement RP tooling and when traditional tooling would be best. The results of the physical testing and economic analysis has shown that RP tooling is able to achieve a number of the research objectives, namely

  11. Exploring the Contemporary Stage and Scripts for the Enactment of Dying Roles: A Narrative Review of the Literature.

    PubMed

    Lowrie, Daniel; Ray, Robin; Plummer, David; Yau, Matthew

    2018-03-01

    This narrative review explores the literature regarding the drama of dying from several academic perspectives. Three key themes were identified including "The impact of blurred boundaries on roles and transitions," "The orchestration of death and dying through time," and "Contemporary dying and new machinery of control." This review reveals the manner in which tightly scripted dying roles serve the needs of the living to a greater extent than those of the dying, by ensuring the depiction of both dying and death as phenomena which have been brought under the control of the living, thereby countering death anxiety. An incongruence between the actual experience of dying and contemporary dying scripts is also highlighted. The authors argue that this incongruence is hidden from the broader societal audience through the maintenance of a dying role that demands serenity and acceptance, thus downplaying or even hiding the actual end-of-life experiences of the dying themselves.

  12. Marginal adaptation of four inlay casting waxes on stone, titanium, and zirconia dies.

    PubMed

    Michalakis, Konstantinos X; Kapsampeli, Vassiliki; Kitsou, Aikaterini; Kirmanidou, Yvone; Fotiou, Anna; Pissiotis, Argirios L; Calvani, Pasquale Lino; Hirayama, Hiroshi; Kudara, Yukio

    2014-07-01

    Different inlay casting waxes do not produce copings with satisfactory marginal accuracy when used on different die materials. The purpose of this study was to evaluate the marginal accuracy of 4 inlay casting waxes on stone dies and titanium and zirconia abutments and to correlate the findings with the degree of wetting between the die specimens and the inlay casting waxes. The inlay casting waxes tested were Starwax (Dentaurum), Unterziehwachs (Bredent), SU Esthetic wax (Schuler), and Sculpturing wax (Renfert). The marginal opening of the waxes was measured with a stereomicroscope on high-strength stone dies and on titanium and zirconia abutments. Photographic images were obtained, and the mean marginal opening for each specimen was calculated. A total of 1440 measurements were made. Wetting between die materials and waxes was determined after fabricating stone, titanium, and zirconia rectangular specimens. A calibrated pipette was used to place a drop of molten wax onto each specimen. The contact angle was calculated with software after an image of each specimen had been made with a digital camera. Collected data were subjected to a 2-way analysis of variance (α=.05). Any association between marginal accuracy and wetting of different materials was found by using the Pearson correlation. The wax factor had a statistically significant effect both on the marginal discrepancy (F=158.31, P<.001) and contact angle values (F=68.09, P<.001). A statistically significant effect of the die material factor both on the marginal adaptation (F=503.47, P<.001) and contact angle values (F=585.02, P<.001) was detected. A significant correlation between the marginal accuracy and the contact angle values (Pearson=0.881, P=.01) was also found. Stone dies provided wax copings with the best marginal integrity, followed by titanium and zirconia abutments. Unterziehwachs (Bredent), wax produced the best marginal adaptation on different die materials. A significant correlation was found

  13. Multicenter Retrospective Cohort Study of "Talk and Die" After Traumatic Brain Injury.

    PubMed

    Shibahashi, Keita; Sugiyama, Kazuhiro; Okura, Yoshihiro; Hoda, Hidenori; Hamabe, Yuichi

    2017-11-01

    Patients who "talk and die" after traumatic brain injury (TBI) are potentially salvageable. The reported incidences and risk factors for the "talk and die" phenomenon are conflicting and do not take into account recent improvements in trauma care. The aim of this study was to determine the incidences of "talk and die" after TBI in a modern trauma care system, as well as associated risk factors. We identified patients who experienced TBI (abbreviated injury scale 3-5) between 2004 and 2015 who talked on admission (i.e., their verbal component on the Glasgow Coma Scale was ≥3 on admission) using a nationwide trauma registry (the Japan Trauma Data Bank). The end point was in-hospital mortality. We compared patients who talked and died with those who talked and survived. During the study period, 236,698 patients were registered in the database. Of the 24,833 patients who were eligible for analysis, 956 (4.0%) patients subsequently died in the hospital. The in-hospital mortality rate significantly decreased over the past 12 years. Older age; male sex; a higher injury severity score; a lower Glasgow Coma Scale score; comorbidities (congestive heart failure, chronic kidney disease, liver cirrhosis, and hematologic disorders); hypotension on arrival; subdural hemorrhage; contusion; and vault fracture were independently associated with higher in-hospital mortality. Even in modern trauma care systems, some patients still talk and die after TBI. We identified certain risk factors in patients with TBI that elicit the requirement for close observation, even if these patients talk after TBI. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Gesellschaft, Lebensgemeinschaft, Ökosystem - Über die Kongruenz von politischen und ökologischen Theorien der Entwicklung

    NASA Astrophysics Data System (ADS)

    Voigt, Annette

    Im Jahr 1859 veröffentlichte Charles Darwin "On the Origin of Species“. Seine Evolutionstheorie ist das wohl spektakulärste Beispiel einer naturwissenschaftlichen Theorie großer gesellschaftlicher Relevanz. Ihre verschiedenen Facetten wurden in der Öffentlichkeit kontrovers diskutiert, unter anderem auch ihre Anwendung zur Erklärung von Zuständen und Prozessen menschlicher Gesellschaften. Zum Teil wurde die Seiensweise der Natur - scheinbar unabhängig von gesellschaftlichen Interessen - für die Erklärung und Legitimation gesellschaftlicher Zustände oder die Legitimation von politischen Ideologien herangezogen (Sozialdarwinismus). Denn Gesellschaft funktioniere ja so, wie Darwin die Natur erklärt habe: es herrsche z. B. Konkurrenzkampf, Auslese und Arbeitsteilung, Erfolg hätten diejenigen, die sich an die Bedingungen am Besten anpassten.

  15. Dying with dignity: a concept analysis.

    PubMed

    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.

  16. Die-target for dynamic powder consolidation

    DOEpatents

    Flinn, J.E.; Korth, G.E.

    1985-06-27

    A die/target is disclosed for consolidation of a powder, especially an atomized rapidly solidified metal powder, to produce monoliths by the dynamic action of a shock wave, especially a shock wave produced by the detonation of an explosive charge. The die/target comprises a rectangular metal block having a square primary surface with four rectangular mold cavities formed therein to receive the powder. The cavities are located away from the geometrical center of the primary surface and are distributed around such center while also being located away from the geometrical diagonals of the primary surface to reduce the action of reflected waves so as to avoid tensile cracking of the monoliths. The primary surface is covered by a powder retention plate which is engaged by a flyer plate to transmit the shock wave to the primary surface and the powder. Spawl plates are adhesively mounted on other surfaces of the block to act as momentum traps so as to reduce reflected waves in the block. 4 figs.

  17. Increasing of the lifetime of large forging dies by repairwelding

    NASA Astrophysics Data System (ADS)

    Duchek, M.; Koukolikova, M.; Kotous, J.; Majer, M.

    2018-02-01

    Repair welding is often used for rebuilding discarded or failed forging dies. It saves the cost of new tools. Increased useful life of repaired dies is another motivation for repair welding. This article focuses on the development of new filler materials for this purpose. The main goal was to prolong the life of tools of DIN 1.2714 material. Filler wires of two chemistries were made and several samples were experimentally welded. Metallographic and tribological analyses were carried out.

  18. Ways to Improve the Quality of Die Steel 5KhNM

    NASA Astrophysics Data System (ADS)

    Efimov, S. V.; Malykhina, O. Yu; Pavlova, A. G.; Milyuts, V. G.; Tsukanov, V. V.; Vikharev, V. V.

    2017-12-01

    There was performed an analysis of influence of the deoxidation technology, hydrogen content and high concentration of titanium in steel 5KhNM (Rus. “5XHM”) on quality of die blanks, evaluated based on the results of the ultrasonic test. The fractographic examinations of fractures and the X-ray microprobe analysis of chemical composition of non-metallic inclusions were conducted, the evaluation of macro- and micro-structure of a die blank with high titanium content was performed. It is demonstrated that defects of dies from steel 5KhNM (Rus. “5XHM”) are cracks from merged flakes and micro-flakes; in most cases large concentrations of sulphides appeared to be hydrogen collectors for formation of flakes and micro-flakes.

  19. Communicating With Dying Patients and Their Families: Multimedia Training in End-of-Life Care.

    PubMed

    Chappell, Phylliss M; Healy, Jennifer; Lee, Shuko; Medellin, Glen; Sanchez-Reilly, Sandra

    2017-08-01

    The need for end-of-life (EOL), high-impact education initiatives to prepare medical students to communicate with dying patients and their families and to cope with issues of death and dying, is well recognized. Third-year medical students (n = 224), during their ambulatory rotation, completed a multimedia EOL curriculum, which included pre-/posttests, an online case-based module, didactic presentation, and a tablet computer application designed to demonstrate the signs and symptoms seen in the last hours of life for families of dying patients. Pre- and posttests were compared using Pearson χ 2 or Fisher exact test, and improvement was measured by weighted κ coefficient. On preintervention surveys, the majority of students demonstrated positive attitudes toward the care of dying patients and their families. Despite this high pretest positive attitude, there was a statistically significant overall positive attitude change after the intervention. The lowest pretest positive attitudes and lowest posttest positive attitude shifts, although all statistically improved, involved addressing the thoughts and feelings of dying patients and in coping with their own emotional response. Medical students exposure to this multimedia EOL curriculum increases positive attitudes in caring for dying patients and their families.

  20. Multi-objective optimization of swash plate forging process parameters for the die wear/service life improvement

    NASA Astrophysics Data System (ADS)

    Hu, X. F.; Wang, L. G.; Wu, H.; Liu, S. S.

    2017-12-01

    For the forging process of the swash plate, the author designed a kind of multi-index orthogonal experiment. Based on the Archard wear model, the influences of billet temperature, die temperature, forming speed, top die hardness and friction coefficient on forming load and die wear were numerically simulated by DEFORM software. Through the analysis of experimental results, the best forging process parameters were optimized and determined, which could effectively reduce the die wear and prolong the die service life. It is significant to increase the practical production of enterprise, especially to reduce the production cost and to promote enterprise profit.

  1. Precision technique for trimming dies using a magnification device.

    PubMed

    Beck, D B

    1980-05-01

    This article described a technique for trimming a die under magnification. However, the microscope is also useful for checking (1) margins of wax patterns for completeness, (2) the internal surfaces of castings for imperfections, bubbles, or retained investment particles which could prevent proper seating of the castings on the dies, (3) for cracks or contamination in dental porcelain as well as porcelain flash on margins; and (4) precision attachment operation after casting or soldering procedures. Attention to detail in these laboratory procedures greatly improves the final fit of dental castings and saves subsequent chairside adjustments and remakes.

  2. Asymmetric Die Grows Purer Silicon Ribbon

    NASA Technical Reports Server (NTRS)

    Kalejs, J. P.; Chalmers, B.; Surek, T.

    1983-01-01

    Concentration of carbide impurities in silicon ribbon is reduced by growing crystalline ribbon with die one wall higher than other. Height difference controls shape of meniscus at liquid/crystal interface and concentrates silicon carbide impurity near one of broad faces. Opposite face is left with above-average purity. Significantly improves efficiency of solar cells made from ribbon.

  3. The Hospice: Advocate for the Dying.

    ERIC Educational Resources Information Center

    Anspaugh, David J.

    1978-01-01

    The hospice philosophy seeks to meet the needs of dying patients and their families. These needs include: effective control of pain; to be loved and to alleviate loneliness; to retain dignity and maintain control of as many aspects of life as possible; and to help the family be supportive and adapt to their inevitable loss. (JMF)

  4. Improving the automated optimization of profile extrusion dies by applying appropriate optimization areas and strategies

    NASA Astrophysics Data System (ADS)

    Hopmann, Ch.; Windeck, C.; Kurth, K.; Behr, M.; Siegbert, R.; Elgeti, S.

    2014-05-01

    The rheological design of profile extrusion dies is one of the most challenging tasks in die design. As no analytical solution is available, the quality and the development time for a new design highly depend on the empirical knowledge of the die manufacturer. Usually, prior to start production several time-consuming, iterative running-in trials need to be performed to check the profile accuracy and the die geometry is reworked. An alternative are numerical flow simulations. These simulations enable to calculate the melt flow through a die so that the quality of the flow distribution can be analyzed. The objective of a current research project is to improve the automated optimization of profile extrusion dies. Special emphasis is put on choosing a convenient starting geometry and parameterization, which enable for possible deformations. In this work, three commonly used design features are examined with regard to their influence on the optimization results. Based on the results, a strategy is derived to select the most relevant areas of the flow channels for the optimization. For these characteristic areas recommendations are given concerning an efficient parameterization setup that still enables adequate deformations of the flow channel geometry. Exemplarily, this approach is applied to a L-shaped profile with different wall thicknesses. The die is optimized automatically and simulation results are qualitatively compared with experimental results. Furthermore, the strategy is applied to a complex extrusion die of a floor skirting profile to prove the universal adaptability.

  5. Natural law and the "right to die".

    PubMed

    Whiting, R A

    Over the last two decades social concerns with the "right to die" have grown beyond the ability of our governmental and judicial institutions to consistently deal with them. One reason for this difficulty has been the unavailability of any legal or judicial standard that is consistent with American conceptions of liberty, morality, and justice. This article attempts to examine the theory of natural law to determine whether it may provide a consistent standard for resolving these difficult questions. As natural law theories are traced through history, they lead directly to the United States where a uniquely American interpretation became one of the foundational principles for our constitution. By applying these theories to the contemporary question of the "right to die," natural law can again provide the foundational principles needed to develop standards for dealing with such questions that are consistent with our historical, philosophical, and political traditions.

  6. A simplified simulation model for a HPDC die with conformal cooling channels

    NASA Astrophysics Data System (ADS)

    Frings, Markus; Behr, Marek; Elgeti, Stefanie

    2017-10-01

    In general, the cooling phase of the high-pressure die casting process is based on complex physical phenomena: so-lidification of molten material; heat exchange between cast part, die and cooling fluid; turbulent flow inside the cooling channels that needs to be considered when computing the heat flux; interdependency of properties and temperature of the cooling liquid. Intuitively understanding and analyzing all of these effects when designing HPDC dies is not feasible. A remedy that has become available is numerical design, based for example on shape optimization methods. However, current computing power is not sufficient to perform optimization while at the same time fully resolving all physical phenomena. But since in HPDC suitable objective functions very often lead to integral values, e.g., average die temperature, this paper identifies possible simplifications in the modeling of the cooling phase. As a consequence, the computational effort is reduced to an acceptable level. A further aspect that arises in the context of shape optimization is the evaluation of shape gradients. The challenge here is to allow for large shape deformations without remeshing. In our approach, the cooling channels are described by their center lines. The flow profile of the cooling fluid is then estimated based on experimental data found in literature for turbulent pipe flows. In combination, the heat flux throughout cavity, die, and cooling channel can be described by one single advection-diffusion equation on a fixed mesh. The parameters in the equation are adjusted based on the position of cavity and cooling channel. Both results contribute towards a computationally efficient, yet accurate method, which can be employed within the frame of shape optimization of cooling channels in HPDC dies.

  7. GPU-basierte Smart Visibility Techniken für die Planung von Tumor-Operationen

    NASA Astrophysics Data System (ADS)

    Tietjen, Christian; Kubisch, Christoph; Hiller, Stefan; Preim, Bernhard

    Bei der Planung von Tumoroperationen ist die Einschätzung von Abständen und Infiltrationen zu vitalen Strukturen wichtig. Im Bereich der medizinischen Visualisierung wurden hierfür bereits zahlreiche Techniken entwickelt, die unter dem Begriff Smart Visibility zusammengefasst werden. Zu diesen zählen Ghost Views und Section Views. In diesem Beitrag wird eine GPU-basierte Realisierung dieser Techniken für polygonale Daten vorgestellt. Die Parametrisierung der Techniken erfolgt automatisch, um einen klinischen Einsatz ermöglichen zu können.

  8. Illustration of cross flow of polystyrene melts through a coathanger die

    NASA Astrophysics Data System (ADS)

    Schöppner, V.; Henke, B.

    2015-05-01

    To design an optimal coathanger die with a uniform flow rate distribution and low pressure drop, it is essential to understand the flow conditions in the die. This is important because the quality of the product is influenced by the flow velocity and the flow rate distribution. In extrusion dies, cross flows also occur in addition to the main flow, which flow perpendicular to the main flow. This results in pressure gradients in the extrusion direction, which have an influence on flow distribution and pressure drop in the die. In recent decades, quantitative representation and analysis of physical flow processes have made considerable progress in predicting the weather, developing drive technologies and designing aircraft using simulation methods and lab trials. Using the flow-line method, the flow is analyzed in flat film extrusion dies with a rectangular cross-section, in particular cross flows. The simplest method to visualize the flow is based on the measurement of obstacle orientation in the flow field by adding individual particles. A near-surface flow field can be visualized by using wool or textile yarns. By sticking thin, frayed at the ends of strands of wool surface that is to be examined cross flows, near-wall profiles of the flow and vortex and separation regions can be visualized. A further possibility is to add glass fibers and analyze the fiber orientation by microscopy and x-ray analysis. In this paper the influence of process parameters (e.g. melt temperatures and throughput) on cross flow and fiber orientation is described.

  9. Development of an Innovative Laser-Assisted Coating Process for Extending Lifetime of Metal Casting Dies. Final Report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Madhav Rao Gonvindaraju

    1999-10-18

    Die casting dies used in the metal casting industry fail due to thermal fatigue cracking accompanied by the presence of residual tensile stresses, corrosion, erosion and wear of die surfaces. This phase 1 SBIR Final Report summarize Karta Technologies research involving the development of an innovative laser coating technology for metal casting dies. The process involves depositing complex protective coatings of nanocrystalline powders of TiC followed by a laser shot peening. The results indicate a significant improvement in corrosion and erosion resistance in molten aluminum for H13 die casting die steels. The laser-coated samples also showed improved surface finish, amore » homogeneous and uniform coating mircrostructure. The technology developed in this research can have a significant impact on the casting industry by saving the material costs involved in replacing dies, reducing downtime and improving the quality.« less

  10. Magnetisches Tracking für die Navigation mit dem da Vinci® Surgical System

    NASA Astrophysics Data System (ADS)

    Nickel, Felix; Wegner, Ingmar; Kenngott, Hannes; Neuhaus, Jochen; Müller-Stich, Beat P.; Meinzer, Hans-Peter; Gutt, Carsten N.

    In dieser Studie wurde untersucht ob in einem typischen OP-Aufbau mit dem da Vinci® Telemanipulator elektromagnetisches Tracking für die Realisation eines Navigationssystems eingesetzt werden kann. Hierfür wurde in einem realen OP-Aufbau untersucht, wie stark metallische und ferromagnetisch wirksame Objekte wie Operationstisch und Telemanipulator das elektromagnetische Feld des Trackingsystems beeinflussen. Die Ergebnisse zeigen, dass der Telemanipulator nur unwesentlich die Störung des Magnetfeldes durch den OP-Tisch verstärkt. Insbesondere die Bewegung der Instrumente im Trackingvolumen verursachte keine zusätzliche relevante Störung des Magnetfeldes. Bei Begrenzung des Trackingvolumens auf eine Länge von 190 mm, Höhe von 200mm und Breite von 400 mm war der maximale Fehler in diesem Bereich an allen Messpunkten kleiner 10 mm. Der Einsatz von elektromagnetischem Tracking für die Navigation mit dem da Vinci® Surgical System ist somit in einem begrenzten Arbeitsvolumen mit hinreichender Genauigkeit möglich.

  11. Hospice nurses’ emotional challenges in their encounters with the dying

    PubMed Central

    Ingebretsen, Lina Paola; Sagbakken, Mette

    2016-01-01

    The purpose of this study was to explore nurses’ emotional challenges when caring for the dying in hospices. The study has a qualitative design, and knowledge was developed through a dialectical exchange between theory and data. Ten individual in-depth interviews were conducted with nurses recruited from two hospices in Denmark. Although all of the nurses said that they experienced emotional challenges or felt emotionally touched during their work, the study found a variety of opinions related to the extent to which their emotional reactions should be revealed in their role as a hospice professional. The participants described their emotional challenges as being simultaneously draining and enriching experiences leading to personal and professional growth and development. The study may contribute to increased awareness of emotional challenges for hospice nurses, which involve continuous reflection and balancing between meeting the dying as a human being and meeting the dying as a hospice professional. PMID:27258584

  12. A Dying Star in a Different Light

    NASA Image and Video Library

    2010-11-17

    This image composite shows two views of a puffy, dying star, or planetary nebula, known as NGC 1514. At left is a view from a ground-based, visible-light telescope; the view on the right shows the object in infrared light from NASA WISE telescope.

  13. Die Struktur von schlankem Materialfluss mit Lean Production Kanban und Innovationen

    NASA Astrophysics Data System (ADS)

    Scheid, Wolf-Michael

    In der Literatur wird Materialfluss überwiegend in Spezialdisziplinen betrachtet, etwa der Steuerungslogik, der Logistiktechnik oder dem Supply Chain Management. Ein charakterisierendes Merkmal des Materialflusses ist jedoch, dass er sich aus vielfältigen Einzelbausteinen zusammensetzt, die alle harmonisch abgestimmt sein müssen. Die maximal erreichbare Effizienz wird nicht durch Höchstleistungen in dem einen oder anderen Spezialthema bestimmt, sondern durch das schwächste Glied im gesamten komplexen Netzwerk. Den Schnittstellen zwischen den betroffenen Fachbereichen in einem Unternehmen kommt hier eine ganz besondere Bedeutung zu: Erst ein harmonischer Einklang ermöglicht hohe Effektivität. Dies setzt umfassendes Verständnis für interdisziplinäre Notwendigkeiten, ein hohes Maß an Abstimmung mit den operativen Prozessen und letztlich einen einvernehmlichen Umgang und den Respekt vor den Problemstellungen des Anderen voraus.

  14. Long-term lumen depreciation behavior and failure modes of multi-die array LEDs

    NASA Astrophysics Data System (ADS)

    Jayawardena, Asiri; Marcus, Daniel; Prugue, Ximena; Narendran, Nadarajah

    2013-09-01

    One of the main advantages of multi-die array light-emitting diodes (LEDs) is their high flux density. However, a challenge for using such a product in lighting fixture applications is the heat density and the need for thermal management to keep the junction temperatures of all the dies low for long-term reliable performance. Ten multi-die LED array samples for each product from four different manufacturers were subjected to lumen maintenance testing (as described in IES-LM-80-08), and their resulting lumen depreciation and failure modes were studied. The products were tested at the maximum case (or pin) temperature reported by the respective manufacturer by appropriately powering the LEDs. In addition, three samples for each product from two different manufacturers were subjected to rapid thermal cycling, and the resulting lumen depreciation and failure modes were studied. The results showed that the exponential lumen decay model using long-term lumen maintenance data as recommended in IES TM-21 does not fit for all package types. The failure of a string of dies and single die failure in a string were observed in some of the packages.

  15. Prolonging dying is the same as prolonging living--one more response to Long.

    PubMed Central

    Kuhse, H; Singer, P

    1991-01-01

    In earlier publications, we had argued that Paul Ramsey is inconsistent because he simultaneously asserts that (i) 'all our days and years are of equal worth' and (ii) 'that it is permissible to refrain from prolonging the lives of some dying patients'. Thomas Long has suggested that we have not shown that Paul Ramsey is inconsistent. Ramsey and we, he holds, start from incommensurable metaphysical views: for Ramsey, the dying process has religious significance--God is calling his servant home. While it is normally a good thing to keep a patient alive, it would, for Ramsey, show deafness to God's call to keep a dying patient alive. It is true we do not share Paul Ramsey's religious views. It is, however, not necessary to rely on any particular metaphysical views to refute Ramsey's position. For Ramsey's view to be internally consistent, Ramsey would have to be able to distinguish between dying and non-dying patients. We examine some of Ramsey's examples and show that his practical judgements do not allow us to draw this distinction. This means that, contra Long, we hold fast to our charge that Ramsey's view is inconsistent. PMID:1787522

  16. Chandra Observations of Dying Radio Sources in Galaxy Clusters

    NASA Technical Reports Server (NTRS)

    Murgia, M.; Markevitch, M.; Govoni, F.; Parma, P.; Fanti, R.; de Ruiter, H. R.; Mack, K.-H.

    2012-01-01

    Context. The dying radio sources represent a very interesting and largely unexplored stage of the active galactic nucleus (AGN) evolution. They are considered to be very rare, and almost all of the few known ones were found in galaxy clusters. However, considering the small number detected so far, it has not been possible to draw any firm conclusions about their X-ray environment. Aims. We present X-ray observations performed with the Chandra satellite of the three galaxy clusters Abell 2276, ZwCl 1829.3+6912, and RX J1852.1+5711, which harbor at their center a dying radio source with an ultra-steep spectrum that we recently discovered. Methods. We analyzed the physical properties of the X-ray emitting gas surrounding these elusive radio sources. We determined the global X-ray properties of the clusters, derived the azimuthally averaged profiles of metal abundance, gas temperature, density, and pressure. Furthermore, we estimated the total mass profiles. Results. The large-scale X-ray emission is regular and spherical, suggesting a relaxed state for these systems. Indeed, we found that the three clusters are also characterized by significant enhancements in the metal abundance and declining temperature profiles toward the central region. For all these reasons, we classified RX J1852.1+5711, Abell 2276, and ZwCl 1829.3+6912 as cool-core galaxy clusters. Conclusions. We calculated the non-thermal pressure of the radio lobes assuming that the radio sources are in the minimum energy condition. For all dying sources we found that this is on average about one to two orders of magnitude lower than that of the external gas, as found for many other radio sources at the center of galaxy groups and clusters. We found marginal evidence for the presence of X-ray surface brightness depressions coincident with the fossil radio lobes of the dying sources in A2276 and ZwCl 1829.3+691. We estimated the outburst age and energy output for these two dying sources. The energy power from

  17. Die Baukastensystematik in der Fördertechnik

    NASA Astrophysics Data System (ADS)

    Sebulke, Johannes

    In der Fördertechnik wird kaum ein größerer Einsatzfall so dem anderen gleichen, dass man zwei Anlagen nach denselben Zeichnungen fertigen kann. Konstruktionszeiten, Rüst- und Umstellungszeiten der Fertigung sind hoch; der Kunde muss bei Einzelanfertigung lange Lieferzeiten in Kauf nehmen. In der Fördertechnik haben sich daher Baukastenprinzip, Standardisierung und die Konstruktion von Erzeugnisreihen weitgehend durchgesetzt.

  18. Results from prototype die-to-database reticle inspection system

    NASA Astrophysics Data System (ADS)

    Mu, Bo; Dayal, Aditya; Broadbent, Bill; Lim, Phillip; Goonesekera, Arosha; Chen, Chunlin; Yeung, Kevin; Pinto, Becky

    2009-03-01

    A prototype die-to-database high-resolution reticle defect inspection system has been developed for 32nm and below logic reticles, and 4X Half Pitch (HP) production and 3X HP development memory reticles. These nodes will use predominantly 193nm immersion lithography (with some layers double patterned), although EUV may also be used. Many different reticle types may be used for these generations including: binary (COG, EAPSM), simple tritone, complex tritone, high transmission, dark field alternating (APSM), mask enhancer, CPL, and EUV. Finally, aggressive model based OPC is typically used, which includes many small structures such as jogs, serifs, and SRAF (sub-resolution assist features), accompanied by very small gaps between adjacent structures. The architecture and performance of the prototype inspection system is described. This system is designed to inspect the aforementioned reticle types in die-todatabase mode. Die-to-database inspection results are shown on standard programmed defect test reticles, as well as advanced 32nm logic, and 4X HP and 3X HP memory reticles from industry sources. Direct comparisons with currentgeneration inspection systems show measurable sensitivity improvement and a reduction in false detections.

  19. High pressure die casting of Fe-based metallic glass.

    PubMed

    Ramasamy, Parthiban; Szabo, Attila; Borzel, Stefan; Eckert, Jürgen; Stoica, Mihai; Bárdos, András

    2016-10-11

    Soft ferromagnetic Fe-based bulk metallic glass key-shaped specimens with a maximum and minimum width of 25.4 and 5 mm, respectively, were successfully produced using a high pressure die casting (HPDC) method, The influence of die material, alloy temperature and flow rate on the microstructure, thermal stability and soft ferromagnetic properties has been studied. The results suggest that a steel die in which the molten metal flows at low rate and high temperature can be used to produce completely glassy samples. This can be attributed to the laminar filling of the mold and to a lower heat transfer coefficient, which avoids the skin effect in the steel mold. In addition, magnetic measurements reveal that the amorphous structure of the material is maintained throughout the key-shaped samples. Although it is difficult to control the flow and cooling rate of the molten metal in the corners of the key due to different cross sections, this can be overcome by proper tool geometry. The present results confirm that HPDC is a suitable method for the casting of Fe-based bulk glassy alloys even with complex geometries for a broad range of applications.

  20. High pressure die casting of Fe-based metallic glass

    NASA Astrophysics Data System (ADS)

    Ramasamy, Parthiban; Szabo, Attila; Borzel, Stefan; Eckert, Jürgen; Stoica, Mihai; Bárdos, András

    2016-10-01

    Soft ferromagnetic Fe-based bulk metallic glass key-shaped specimens with a maximum and minimum width of 25.4 and 5 mm, respectively, were successfully produced using a high pressure die casting (HPDC) method, The influence of die material, alloy temperature and flow rate on the microstructure, thermal stability and soft ferromagnetic properties has been studied. The results suggest that a steel die in which the molten metal flows at low rate and high temperature can be used to produce completely glassy samples. This can be attributed to the laminar filling of the mold and to a lower heat transfer coefficient, which avoids the skin effect in the steel mold. In addition, magnetic measurements reveal that the amorphous structure of the material is maintained throughout the key-shaped samples. Although it is difficult to control the flow and cooling rate of the molten metal in the corners of the key due to different cross sections, this can be overcome by proper tool geometry. The present results confirm that HPDC is a suitable method for the casting of Fe-based bulk glassy alloys even with complex geometries for a broad range of applications.

  1. High pressure die casting of Fe-based metallic glass

    PubMed Central

    Ramasamy, Parthiban; Szabo, Attila; Borzel, Stefan; Eckert, Jürgen; Stoica, Mihai; Bárdos, András

    2016-01-01

    Soft ferromagnetic Fe-based bulk metallic glass key-shaped specimens with a maximum and minimum width of 25.4 and 5 mm, respectively, were successfully produced using a high pressure die casting (HPDC) method, The influence of die material, alloy temperature and flow rate on the microstructure, thermal stability and soft ferromagnetic properties has been studied. The results suggest that a steel die in which the molten metal flows at low rate and high temperature can be used to produce completely glassy samples. This can be attributed to the laminar filling of the mold and to a lower heat transfer coefficient, which avoids the skin effect in the steel mold. In addition, magnetic measurements reveal that the amorphous structure of the material is maintained throughout the key-shaped samples. Although it is difficult to control the flow and cooling rate of the molten metal in the corners of the key due to different cross sections, this can be overcome by proper tool geometry. The present results confirm that HPDC is a suitable method for the casting of Fe-based bulk glassy alloys even with complex geometries for a broad range of applications. PMID:27725780

  2. Influence of polyurethane resin dies on the fit and adaptation of full veneer crowns.

    PubMed

    Lillywhite, Graeme R R; Vohra, Fahim

    2015-01-01

    Polyurethane resin is a possible alternative to type IV dental stone for fabrication of indirect restorations however its dimensional accuracy is questionable. The aim was to investigate the dimensional accuracy of silica filled polyurethane resin die material by evaluating the marginal fit and adaptation of indirect gold castings. Experimental, in vitro study. Totally 40 copper plated replicas of a nickel chrome master die analogous to a veneer gold crown preparation were made and impressions recorded using polyvinylsiloxane material. Twenty impressions were poured in type IV dental stone (control group (Vel-mix, Kerr, UK) and the remaining (n = 20) in silica filled polyurethane die material (test group) (Alpha Die MF, CA, USA). Gold castings were fabricated for each die using standardized techniques. The castings were seated on their respective copper plated dies, embedded in resin and sectioned. The specimens were analyzed by measuring marginal opening and the area beneath the casting at a ×63 magnification and using image analysis software. Data were analyzed using a Student's t-test. No significant difference was observed between the experimental groups (P > 0.05). The mean marginal opening for type IV, dental stone and polyurethane resin, was 57 ± 22.6 μm and 63.47 ± 27.1 μm, respectively. Stone displayed a smaller area beneath the casting (31581 ± 16297 μm 2 ) as compared to polyurethane resin (35003 ± 23039 μm 2 ). The fit and adaptation of indirect gold castings made on polyurethane and type IV dental stone dies were comparable.

  3. A Module on Death and Dying to Develop Empathy in Student Pharmacists

    PubMed Central

    Olin, Jacqueline L.; Thornton, Phillip L.; Dolder, Christian R.; Hanrahan, Conor

    2011-01-01

    Objective To implement an integrated module on death and dying into a 15-week bioethics course and determine whether it increased student pharmacists’ empathy. Design Students participated in a 5-week death and dying module that included presentation of the film Wit, an interactive lecture on hospice, and a lecture on the ethics of pain management. Assessment Fifty-six students completed the 30-item Balanced Emotional Empathy Scale (BEES) before and after completing the module and wrote a reflective essay. Students demonstrated an appreciation of patient-specific values in their essay. Quantitative data collected via BEES scores demonstrated significant improvement in measured empathy. Conclusion A 5-week instructional model on death and dying significantly increased student empathy. PMID:21769147

  4. Self-determination, the right to die, and culture: a literature review.

    PubMed

    McCormick, Andrew J

    2011-04-01

    Self-determination is a primary ethical principle underlying social work practice in health care settings. Since the 1970s, a right-to-die movement that shares the social work commitment to self-determination has grown and influences end-of-life care decisions. However, the role of culture is notably absent in discussions of the right to die. A literature review was conducted to explore self-determination and the role of culture in the context of the history of the right-to-die movement. A total of 54 articles met the criteria for inclusion in the review. Of the total, 21 related to self-determination, and 12 related to ethnicity and culture at the end of life. A history based on the review of the right-to-die movement is presented. The review found that social workers support passively hastening death and that views of self-determination are affected by both law and culture. In response, social workers will face three tasks: (1) becoming more public in their support for client self-determination as an important standard in end-of-life care, (2) being more explicit in support of diverse cultural traditions in end-of-life decision making, and (3) expanding their traditional educational and bridging roles between families and medical personnel.

  5. Dying at home: experience of the Verdun local community service centre.

    PubMed

    Kiyanda, Brigitte Gagnon; Dechêne, Geneviève; Marchand, Robert

    2015-04-01

    To demonstrate that it is possible for a team of palliative care nurses in an urban centre to care for more than 50% of their terminally ill patients at home until they die, and that medical care delivered in the home is a determining factor in death at home versus death in a hospital. Analysis of place of death of terminally ill patients who died in 2012 and 2013 (N = 212) and who had been cared for by palliative care nurses, by type of medical care. The centre local de services communautaires (CLSC) in Verdun, Que, an urban neighbourhood in southwest Montreal. A total of 212 terminally ill patients. Rate of deaths at home. Of the 212 patients cared for at home by palliative care nurses, 56.6% died at home; 62.6% received medical home care from CLSC physicians, compared with 5.0% who did not receive medical home care from any physician. Combined with a straightforward restructuring of the nursing care delivered by CLSCs, development of medical services delivered in the home would enable the more than 50% of terminally ill patients in Quebec who are cared for by CLSCs to die at home--something that most of them wish for. Copyright© the College of Family Physicians of Canada.

  6. The case for a sociology of dying, death, and bereavement.

    PubMed

    Thompson, Neil; Allan, June; Carverhill, Philip A; Cox, Gerry R; Davies, Betty; Doka, Kenneth; Granek, Leeat; Harris, Darcy; Ho, Andy; Klass, Dennis; Small, Neil; Wittkowski, Joachim

    2016-01-01

    Dying, death, and bereavement do not occur in a social vacuum. How individuals and groups experience these phenomena will be largely influenced by the social context in which they occur. To develop an adequate understanding of dying, death, and bereavement we therefore need to incorporate a sociological perspective into our analysis. This article examines why a sociological perspective is necessary and explores various ways in which sociology can be of practical value in both intellectual and professional contexts. A case study comparing psychological and sociological perspectives is offered by way of illustration.

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

    PubMed Central

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

    2013-01-01

    Background. In the end-of-life (EOL) phase, high-grade glioma (HGG) patients have a high symptom burden and often lose independence because of physical and cognitive dysfunction. This might affect the patient's personal dignity. We aimed to (a) assess the proportion of HGG patients dying with dignity as perceived by their relatives and (b) identify disease and care factors correlated with dying with dignity in HGG patients. Methods. 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. Results. 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. Conclusions. 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. PMID:23335620

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

    PubMed

    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.

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

    PubMed

    Yeun, Eunja

    2005-11-01

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

  10. Technische Systeme für den Herzersatz und die Herzunterstützung

    NASA Astrophysics Data System (ADS)

    Schöb, Reto; Loree, Howard M.

    Herzkrankheiten verursachen allein in den Vereinigten Staaten jährlich mehr als 700’000 Todesfälle. Ungefähr 3 Millionen Patienten in den U.S.A. leiden gemäss der American Heart Association (AHA) und dem National Heart, Lung and Blood Institute (NHLBI) an kongestivem Herzversagen (Congestive Heart Failure, CHF), welches eine chronische, sehr entkräftende und degenerative Krankheit ist: Das Herz ist dabei unfähig, hinreichend Blut zu den Organen des Körpers zu pumpen. Über 400’000 Fälle von CHF werden jedes Jahr diagnostiziert. Ähnliche Zahlen werden für Europa und Japan zusammen geschätzt. Basierend auf Daten vom AHA und NHLBI beträgt die fünfjährige Überlebensrate für CHF-Patienten lediglich etwa 50% [1]. 70’000-120’000 dieser Patienten könnten von einer Herzverpflanzung profitieren. 1999 wurden in den USA aber nur 2185 Herztransplantationen durchgeführt während die Warteliste über 4000 Patienten beträgt [2]. Ein akuter Mangel an Spenderherzen und die enormen Kosten (250’000-400’000 USD pro Patient) sind die begrenzenden Faktoren für Herztransplantationen [3]. Dies bedeutet, dass eine riesige Anzahl von Patienten durch ein zuverlässiges und verschleissfreies, nichtthrombotisches, total implantierbares, künstliches Herz gerettet werden könnten. Bis heute jedoch kein derartiges Implantat kommerziell verfügbar.

  11. Imagining the alternatives to life prolonging treatments: elders' beliefs about the dying experience.

    PubMed

    Winter, Laraine; Parker, Barbara; Schneider, Melissa

    2007-08-01

    Deciding for or against a life-prolonging treatment represents a choice between prolonged life and death. When the death alternative is not described, individuals must supply their own assumptions. How do people imagine the experience of dying? We asked 40 elderly people open-ended questions about dying without 4 common life-prolonging treatments, eliciting beliefs about pain, length of time, loneliness, and palliative care. Beliefs were diverse, loneliness was commonly assumed, and palliation was rarely mentioned spontaneously. Results underscore needs for improved understanding of the dying process and palliative care and for fuller communication between patients and healthcare providers.

  12. WAMA: a method of optimizing reticle/die placement to increase litho cell productivity

    NASA Astrophysics Data System (ADS)

    Dor, Amos; Schwarz, Yoram

    2005-05-01

    This paper focuses on reticle/field placement methodology issues, the disadvantages of typical methods used in the industry, and the innovative way that the WAMA software solution achieves optimized placement. Typical wafer placement methodologies used in the semiconductor industry considers a very limited number of parameters, like placing the maximum amount of die on the wafer circle and manually modifying die placement to minimize edge yield degradation. This paper describes how WAMA software takes into account process characteristics, manufacturing constraints and business objectives to optimize placement for maximum stepper productivity and maximum good die (yield) on the wafer.

  13. HVM die yield improvement as a function of DRSEM ADC

    NASA Astrophysics Data System (ADS)

    Maheshwary, Sonu; Haas, Terry; McGarvey, Steve

    2010-03-01

    Given the current manufacturing technology roadmap and the competitiveness of the global semiconductor manufacturing environment in conjunction with the semiconductor manufacturing market dynamics, the market place continues to demand a reduced die manufacturing cost. This continuous pressure on lowering die cost in turn drives an aggressive yield learning curve, a key component of which is defect reduction of manufacturing induced anomalies. In order to meet and even exceed line and die yield targets there is a need to revamp defect classification strategies and place a greater emphasize on increasing the accuracy and purity of the Defect Review Scanning Electron Microscope (DRSEM) Automated Defect Classification (ADC) results while placing less emphasis on the ADC results of patterned/un-patterned wafer inspection systems. The increased emphasis on DRSEM ADC results allows for a high degree of automation and consistency in the classification data and eliminates variance induced by the manufacturing staff. This paper examines the use of SEM based Auto Defect Classification in a high volume manufacturing environment as a key driver in the reduction of defect limited yields.

  14. Talking it out: helping our patients live better while dying.

    PubMed

    Zeytinoglu, Meltem

    2011-06-21

    Although dying is an inevitable part of the life cycle, there has been extensive political debate over end-of-life care. Participating in end-of-life care conversations can be emotionally challenging for everyone involved. Messages about serious or terminal illnesses can be very hard for patients and their families to hear, and physicians frequently struggle with the burden of delivering these messages. Still, evidence shows that conversations about end-of-life care options between physicians and patients can improve the quality of life of dying patients and help to relieve the emotional burden on surviving loved ones. Legislation to support these discussions by consistently reimbursing physicians for their time spent performing this service has been blocked on multiple occasions. More research on how to improve end-of-life care will enable health care providers to optimize treatment of their patients. Overcoming political divides to support end-of-life care conversations is needed to promote care that is consistent with patients' values and needs and is a key step in encouraging better quality of life for dying patients.

  15. How dying cells alert the immune system to danger

    PubMed Central

    Kono, Hajime; Rock, Kenneth L.

    2009-01-01

    When a cell dies in vivo the event does not go unnoticed. The host has evolved mechanisms to detect the death of cells and rapidly investigate the nature of their demise. If cell death is a result of natural causes, that is, it is part of normal physiological processes, then there is little threat to the organism. In this situation, little else is done other than removing the corpse. However, if cells have died as the consequence of some violence or disease, then both defence and repair mechanisms are mobilized. The importance of this process to host defence and disease pathogenesis has only been appreciated relatively recently. This article will review our current knowledge of these processes. PMID:18340345

  16. Heat damage-free laser-microjet cutting achieves highest die fracture strength

    NASA Astrophysics Data System (ADS)

    Perrottet, Delphine; Housh, Roy; Richerzhagen, Bernold; Manley, John

    2005-04-01

    Unlike conventional laser-based technologies, the water jet guided laser does not generate heat damage and contamination is also very low. The negligible heat-affected zone is one reason why die fracture strength is higher than with sawing. This paper first presents the water jet guided laser technology and then explains how it differs from conventional dry laser cutting. Finally, it presents the results obtained by three recent studies conducted to determine die fracture strength after Laser-Microjet cutting.

  17. Moral distress and providing care to dying babies in neonatal nursing.

    PubMed

    Kain, Victoria J

    2007-05-01

    Moral distress in nursing is a prevalent theme in the literature. Although this issue has been investigated in other nursing disciplines, it has not been investigated by empirical research in the emotionally and ethically sensitive area of providing care to dying babies. Moral distress occurs when nurses are prevented from translating moral choices into moral action. The response to moral distress is anger, resentment, guilt, frustration, sorrow and powerlessness. If not addressed, self-worth may be jeopardised, affecting personal and professional relationships. A review of the literature was conducted to explore moral distress in neonatal nursing when providing care to dying babies. This literature review provides a basis for the direction of further research and hypothesis testing. Further focused research is necessary in this under-theorised area of nursing practice to clarify the significance of moral distress for neonatal nurses caring for dying babies.

  18. Quality insights of university teachers on dying, death, and death education.

    PubMed

    Mak, Mui-Hing June

    One of the main responsibilities of teachers is to help individual students cope with life difficulties such as grief following a death. However, very little research explores teachers' views on death, dying, and how they handle grief and loss in schools. This study aims to explore university teachers' knowledge and attitudes on dying, death, and death education. Fifteen university teachers were recruited using a qualitative method. This study reveals that most teachers' views on death and related issues are largely affected by their death experiences, religious beliefs, professional background, and the mass media. Although they have a general negative response toward death and dying, some teachers begin to affirm their meanings of life and death. Most teachers agree that they do not feel adequate about managing and teaching on life and death issues, so they strongly support including death education in the formal programs in Hong Kong.

  19. Ethics of Death and Dying: Historical Perspective.

    ERIC Educational Resources Information Center

    Gruman, Gerald J.

    1978-01-01

    Argues that the ethical dilemmas surrounding dying and death today can be better understood from a historical perspective. The methodology of intellectual history is employed to examine the sequence of cultural stages from pre-history to the contemporary scene, using the concept of the death system (Kastenbaum) as an organizing formulation.…

  20. Development of Integrated Die Casting Process for Large Thin-Wall Magnesium Applications

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Carter, Jon T.; Wang, Gerry; Luo, Alan

    The purpose of this project was to develop a process and product which would utilize magnesium die casting and result in energy savings when compared to the baseline steel product. The specific product chosen was a side door inner panel for a mid-size car. The scope of the project included: re-design of major structural parts of the door, design and build of the tooling required to make the parts, making of parts, assembly of doors, and testing (both physical and simulation) of doors. Additional work was done on alloy development, vacuum die casting, and overcasting, all in order to improvemore » the performance of the doors and reduce cost. The project achieved the following objectives: 1. Demonstrated ability to design a large thin-wall magnesium die casting. 2. Demonstrated ability to manufacture a large thin-wall magnesium die casting in AM60 alloy. 3. Tested via simulations and/or physical tests the mechanical behavior and corrosion behavior of magnesium die castings and/or lightweight experimental automotive side doors which incorporate a large, thin-wall, powder coated, magnesium die casting. Under some load cases, the results revealed cracking of the casting, which can be addressed with re-design and better material models for CAE analysis. No corrosion of the magnesium panel was observed. 4. Using life cycle analysis models, compared the energy consumption and global warming potential of the lightweight door with those of a conventional steel door, both during manufacture and in service. Compared to a steel door, the lightweight door requires more energy to manufacture but less energy during operation (i.e., fuel consumption when driving vehicle). Similarly, compared to a steel door, the lightweight door has higher global warming potential (GWP) during manufacture, but lower GWP during operation. 5. Compared the conventional magnesium die casting process with the “super-vacuum” die casting process. Results achieved with cast tensile bars suggest some

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

    PubMed

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

    2017-07-19

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

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

    PubMed

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

    2017-12-01

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

  3. Inosine Released from Dying or Dead Cells Stimulates Cell Proliferation via Adenosine Receptors.

    PubMed

    Chen, Jin; Chaurio, Ricardo A; Maueröder, Christian; Derer, Anja; Rauh, Manfred; Kost, Andriy; Liu, Yi; Mo, Xianming; Hueber, Axel; Bilyy, Rostyslav; Herrmann, Martin; Zhao, Yi; Muñoz, Luis E

    2017-01-01

    Many antitumor therapies induce apoptotic cell death in order to cause tumor regression. Paradoxically, apoptotic cells are also known to promote wound healing, cell proliferation, and tumor cell repopulation in multicellular organisms. We aimed to characterize the nature of the regenerative signals concentrated in the micromilieu of dead and dying cells. Cultures of viable melanoma B16F10 cells, mouse fibroblasts, and primary human fibroblast-like synoviocytes (FLS) in the presence of dead and dying cells, their supernatants (SNs), or purified agonists and antagonists were used to evaluate the stimulation of proliferation. Viable cell quantification was performed by either flow cytometry of harvested cells or by crystal violet staining of adherent cells. High-performance liquid chromatography and liquid chromatography coupled with mass spectrometry of cell SNs were deployed to identify the nature of growth-promoting factors. Coimplantation of living cells in the presence of SNs collected from dead and dying cells and specific agonists was used to evaluate tumor growth in vivo . The stimulation of proliferation of few surviving cells by bystander dead cells was confirmed for melanoma cells, mouse fibroblasts, and primary FLS. We found that small soluble molecules present in the protein-free fraction of SNs of dead and dying cells were responsible for the promotion of proliferation. The nucleoside inosine released by dead and dying cells acting via adenosine receptors was identified as putative inducer of proliferation of surviving tumor cells after irradiation and heat treatment. Inosine released by dead and dying cells mediates tumor cell proliferation via purinergic receptors. Therapeutic strategies surmounting this pathway may help to reduce the rate of recurrence after radio- and chemotherapy.

  4. Care of the dying: how do we replace the Liverpool Care Pathway?

    PubMed

    Davis, Charles; Tomas, Jon

    2014-12-01

    Death is an inescapable certainty of life. Variability in care for dying persons, however, is present. The Liverpool Care Pathway (LCP) sought to guide care for the last days of life but was phased out after intense scrutiny. A governmental report and rapid review of evidence were considered alongside mass and social media reporting. An evidence review of end-of-life care was undertaken. Any person's death is inherently challenging. Much consideration must be given to holistic needs when approaching death. Communication skills may be lacking for professional and patient alike. The LCP became flawed in use rather than intention or principle. Seeming financial gains from death were concerning to all. We have responsibility for making choices prospectively in order for them to influence our care when we are dying. Normalization of death is key on both micro- and macro communication levels. Perceptions of relevant terminology; review of the definition of dying; improved recognition of the dying process and measuring the impact of communication skills training. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Impact of Simulation Technology on Die and Stamping Business

    NASA Astrophysics Data System (ADS)

    Stevens, Mark W.

    2005-08-01

    Over the last ten years, we have seen an explosion in the use of simulation-based techniques to improve the engineering, construction, and operation of GM production tools. The impact has been as profound as the overall switch to CAD/CAM from the old manual design and construction methods. The changeover to N/C machining from duplicating milling machines brought advances in accuracy and speed to our construction activity. It also brought significant reductions in fitting sculptured surfaces. Changing over to CAD design brought similar advances in accuracy, and today's use of solid modeling has enhanced that accuracy gain while finally leading to the reduction in lead time and cost through the development of parametric techniques. Elimination of paper drawings for die design, along with the process of blueprinting and distribution, provided the savings required to install high capacity computer servers, high-speed data transmission lines and integrated networks. These historic changes in the application of CAE technology in manufacturing engineering paved the way for the implementation of simulation to all aspects of our business. The benefits are being realized now, and the future holds even greater promise as the simulation techniques mature and expand. Every new line of dies is verified prior to casting for interference free operation. Sheet metal forming simulation validates the material flow, eliminating the high costs of physical experimentation dependent on trial and error methods of the past. Integrated forming simulation and die structural analysis and optimization has led to a reduction in die size and weight on the order of 30% or more. The latest techniques in factory simulation enable analysis of automated press lines, including all stamping operations with corresponding automation. This leads to manufacturing lines capable of running at higher levels of throughput, with actual results providing the capability of two or more additional strokes per

  6. Chandra observations of dying radio sources in galaxy clusters

    NASA Astrophysics Data System (ADS)

    Murgia, M.; Markevitch, M.; Govoni, F.; Parma, P.; Fanti, R.; de Ruiter, H. R.; Mack, K.-H.

    2012-12-01

    Context. The dying radio sources represent a very interesting and largely unexplored stage of the active galactic nucleus (AGN) evolution. They are considered to be very rare, and almost all of the few known ones were found in galaxy clusters. However, considering the small number detected so far, it has not been possible to draw any firm conclusions about their X-ray environment. Aims: We present X-ray observations performed with the Chandra satellite of the three galaxy clusters Abell 2276, ZwCl 1829.3+6912, and RX J1852.1+5711, which harbor at their center a dying radio source with an ultra-steep spectrum that we recently discovered. Methods: We analyzed the physical properties of the X-ray emitting gas surrounding these elusive radio sources. We determined the global X-ray properties of the clusters, derived the azimuthally averaged profiles of metal abundance, gas temperature, density, and pressure. Furthermore, we estimated the total mass profiles. Results: The large-scale X-ray emission is regular and spherical, suggesting a relaxed state for these systems. Indeed, we found that the three clusters are also characterized by significant enhancements in the metal abundance and declining temperature profiles toward the central region. For all these reasons, we classified RX J1852.1+5711, Abell 2276, and ZwCl 1829.3+6912 as cool-core galaxy clusters. Conclusions: We calculated the non-thermal pressure of the radio lobes assuming that the radio sources are in the minimum energy condition. For all dying sources we found that this is on average about one to two orders of magnitude lower than that of the external gas, as found for many other radio sources at the center of galaxy groups and clusters. We found marginal evidence for the presence of X-ray surface brightness depressions coincident with the fossil radio lobes of the dying sources in A2276 and ZwCl 1829.3+691. We estimated the outburst age and energy output for these two dying sources. The energy power from

  7. One Chance to Get it Right: understanding the new guidance for care of the dying person.

    PubMed

    Sykes, Nigel

    2015-09-01

    Following criticism of the Liverpool Care of the Dying Pathway (LCP), widely used to guide care of dying people in British health-care settings, the UK Government set up an independent review which in 2013 recommended that use of the LCP be discontinued. In response, the Leadership Alliance for the Care of Dying People, a coalition of a wide range of stakeholders, recently published guidance entitled One Chance to Get it Right. This guidance contains five Priorities of Care for the dying person that are intended to guide clinical staff and will inform Care Quality Commission inspections of health-care providers. This article summarizes the background to One Chance to Get it Right and the guidance it contains. One Chance to Get it Right, More Care, Less Pathway and related guidance documents. The need to improve the standard of end-of-life care in every clinical setting. The value of a pathway-based approach to end-of-life care in a context where well-implemented programmes of staff education in the subject are lacking. Public concern with, and scrutiny of, the quality of dying in the UK health-care system, particularly in hospitals but also the ability of patients to die well at home where that is their place of choice. Effective methods of teaching end of life care to all clinical staff; the effect upon families of caring for a dying relative at home; the optimum type, quantity and source of external support to informal carers that is perceived by them as adequate and enables the ill person to die well in in their own home; fuller understanding of the physiology of dying. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Seating positions and children's risk of dying in motor vehicle crashes

    PubMed Central

    Braver, E.; Whitfield, R.; Ferguson, S.

    1998-01-01

    Objectives—To determine the effects of seating position, combined with restraint use and airbag status, on children's risk of dying in crashes. Methods—Using 1988–95 data from the United States Fatality Analysis Reporting System, risk of death was compared among front and rear seated passengers aged 12 and younger who were involved in fatal crashes for different categories of restraint use and in vehicles with and without passenger airbags. Results—Restrained children in rear seats had the lowest risk of dying in fatal crashes. Among children seated in the rear, risk of death was reduced 35% in vehicles without any airbags, 31% in vehicles equipped only with driver airbags, and 46% in vehicles with passenger airbags. Both restrained and unrestrained children aged 0–12 were at lower risk of dying in rear seats. Rear seats also afforded additional protection to children aged 5–12 restrained only with lap belts compared with lap/shoulder belted children in front seats. Children were about 10–20% less likely to die in rear center than in rear outboard positions. Conclusions—Parents and others who transport children should be strongly encouraged to place infants and children in rear seats whether or not vehicles have airbags. Existing laws requiring restraint use by children should be strengthened and actively enforced. PMID:9788087

  9. Experiences with and attitudes toward death and dying among homeless persons.

    PubMed

    Song, John; Ratner, Edward R; Bartels, Dianne M; Alderton, Lucy; Hudson, Brenda; Ahluwalia, Jasjit S

    2007-04-01

    Homeless persons face many barriers to health care, have few resources, and experience high death rates. They live lives of disenfranchisement and neglect. Few studies have explored their experiences and attitudes toward death and dying. Unfortunately, studies done in other populations may not apply to homeless persons. Exploring these experiences and attitudes may provide insight into life, health care, and end-of-life (EOL) concerns of this population. To explore the experiences and attitudes toward death and dying among homeless persons. Qualitative study utilizing focus groups. Fifty-three homeless persons recruited from homeless service agencies. In-depth interviews, which were audiotaped and transcribed. We present seven themes, some of which are previously unreported. Homeless persons described many significant experiences with death and dying, and many participants suffered losses while very young. These encounters influenced participants' attitudes toward risks and risky behavior: e.g., for some, these experiences provided justification for high-risk behaviors and influenced their behaviors while living on the streets. For others, they may be associated with their homelessness. Finally, these experiences informed their attitudes toward death and dying as well as EOL care; homeless persons believe that care will be poor at the EOL. Findings from this study have implications for addressing social services, health promotion, prevention, and EOL care for homeless persons, as well as for others who are poor and disenfranchised.

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

    PubMed

    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.

  11. ELID grinding characteristics of large stamping die for Wolter mirror.

    PubMed

    Yin, Shaohui; Ohmori, Hitoshi; Liu, Qing; Morita, Shinnya; Chen, Fengjun; Asami, Muneaki; Fan, Yufeng

    2009-01-01

    An ultra-precision ELID grinding of large stamping dies of Wolter mirror for X-ray telescope was presented in this paper. The large stamping dies (S55C) with confocal paraboloid and hyperboloid was ground by ELID arc-enveloped grinding. In this ELID grinding system, cast iron fiber bonded (CIFB) diamond wheels were controlled by 3-dimentional ways to scan the work-piece and generate required surfaces. Its grinding characteristics such as attainable form accuracy, surface roughness were investigated. Furthermore, some measures to improve form accuracy were discussed and verified such as truing, compensating, and on-machine measuring.

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

    PubMed

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

    2018-06-01

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

  13. Special not different: general practitioners' accounts of their care of dying people.

    PubMed

    Field, D

    1998-05-01

    In modern Britain the majority of terminal care occurs in people's own homes and many dying people and their carers would prefer the death itself to occur in the home. The quality of terminal care in the home and the possibility of a home death depend to a great extent upon the care provided by GPs and community nurses. This paper reports on GPs' experiences of caring for dying people and their attitudes towards such work. It is based on unstructured interviews with 25 GPs who graduated from the 1979 entry cohort to the University of Leicester medical school. The respondents were recruited via a questionnaire following up previous research with this cohort on 'fear of death'. Although self-selecting, interviewees were not significantly different from those who did not volunteer for interview in any of the statistical analyses of the questionnaire data. There were a number of similarities in their accounts of their care of dying people. Common themes were that the care of dying people was important, rewarding and satisfying; that the GPs saw themselves as part of a team of carers, frequently as team co-ordinators; good working relationships with district nurses but less satisfactory relationships with hospitals and social workers; that patient and family were both recipients of care; and honesty in communication with dying people, albeit tempered. Three issues of contemporary relevance were: tensions over the role of hospice and specialist terminal care services; care of people with chronic terminal illnesses other than cancer; and the role of GPs in the social construction of bereavement.

  14. Ageless Aluminum-Cerium-Based Alloys in High-Volume Die Casting for Improved Energy Efficiency

    NASA Astrophysics Data System (ADS)

    Stromme, Eric T.; Henderson, Hunter B.; Sims, Zachary C.; Kesler, Michael S.; Weiss, David; Ott, Ryan T.; Meng, Fanqiang; Kassoumeh, Sam; Evangelista, James; Begley, Gerald; Rios, Orlando

    2018-06-01

    Strong chemical reactions between Al and Ce lead to the formation of intermetallics with exceptional thermal stability. The rapid formation of intermetallics directly from the liquid phase during solidification of Al-Ce alloys leads to an ultrafine microconstituent structure that effectively strengthens as-cast alloys without further microstructural optimization via thermal processing. Die casting is a high-volume manufacturing technology that accounts for greater than 40% of all cast Al products, whereas Ce is highly overproduced as a waste product of other rare earth element (REE) mining. Reducing heat treatments would stimulate significant improvements in manufacturing energy efficiency, exceeding (megatonnes/year) per large-scale heat-treatment line. In this study, multiple compositions were evaluated with wedge mold castings to test the sensitivity of alloys to the variable solidification rate inherent in high-pressure die casting. Once a suitable composition was determined, it was successfully demonstrated at 800 lbs/h in a 600-ton die caster, after which the as-die cast parts performed similarly to ubiquitous A380 in the same geometry without requiring heat treatment. This work demonstrates the compatibility of Al REE alloys with high-volume die-casting applications with minimal heat treatments.

  15. Ageless Aluminum-Cerium-Based Alloys in High-Volume Die Casting for Improved Energy Efficiency

    NASA Astrophysics Data System (ADS)

    Stromme, Eric T.; Henderson, Hunter B.; Sims, Zachary C.; Kesler, Michael S.; Weiss, David; Ott, Ryan T.; Meng, Fanqiang; Kassoumeh, Sam; Evangelista, James; Begley, Gerald; Rios, Orlando

    2018-04-01

    Strong chemical reactions between Al and Ce lead to the formation of intermetallics with exceptional thermal stability. The rapid formation of intermetallics directly from the liquid phase during solidification of Al-Ce alloys leads to an ultrafine microconstituent structure that effectively strengthens as-cast alloys without further microstructural optimization via thermal processing. Die casting is a high-volume manufacturing technology that accounts for greater than 40% of all cast Al products, whereas Ce is highly overproduced as a waste product of other rare earth element (REE) mining. Reducing heat treatments would stimulate significant improvements in manufacturing energy efficiency, exceeding (megatonnes/year) per large-scale heat-treatment line. In this study, multiple compositions were evaluated with wedge mold castings to test the sensitivity of alloys to the variable solidification rate inherent in high-pressure die casting. Once a suitable composition was determined, it was successfully demonstrated at 800 lbs/h in a 600-ton die caster, after which the as-die cast parts performed similarly to ubiquitous A380 in the same geometry without requiring heat treatment. This work demonstrates the compatibility of Al REE alloys with high-volume die-casting applications with minimal heat treatments.

  16. Modeling of microstructure evolution of magnesium alloy during the high pressure die casting process

    NASA Astrophysics Data System (ADS)

    Wu, Mengwu; Xiong, Shoumei

    2012-07-01

    Two important microstructure characteristics of high pressure die cast magnesium alloy are the externally solidified crystals (ESCs) and the fully divorced eutectic which form at the filling stage of the shot sleeve and at the last stage of solidification in the die cavity, respectively. Both of them have a significant influence on the mechanical properties and performance of magnesium alloy die castings. In the present paper, a numerical model based on the cellular automaton (CA) method was developed to simulate the microstructure evolution of magnesium alloy during cold-chamber high pressure die casting (HPDC) process. Modeling of dendritic growth of magnesium alloy with six-fold symmetry was achieved by defining a special neighbourhood configuration and calculating of the growth kinetics from complete solution of the transport equations. Special attention was paid to establish a nucleation model considering both of the nucleation of externally solidified crystals in the shot sleeve and the massive nucleation in the die cavity. Meanwhile, simulation of the formation of fully divorced eutectic was also taken into account in the present CA model. Validation was performed and the capability of the present model was addressed by comparing the simulated results with those obtained by experiments.

  17. Effects of climate-change induced vegetation die-off on soil biodiversity and functioning

    NASA Astrophysics Data System (ADS)

    Curiel Yuste, Jorge; Garcia Angulo, Daniel; Barba, Josep; Poyatos, Rafael

    2017-04-01

    Climate change-induced vegetation die-off is nowadays a widespread phenomenon responsible for limiting the capacity of terrestrial ecosystems to provide essential services worldwide. Less is known, however, about how vegetation die-off relates with changes in the biodiversity and ecology of the soil compartment, which accounts for many of the vital ecosystem functions such as providing essential nutrients for plant growth (nitrogen, N; or phosphorous, P), or long-term carbon (C) sequestration. The death of the vegetation alters soil abiotic (microclimate) conditions and limits the supply of the energy (carbohydrates specially) demanded by the soil biological communities. These abiotic and biotic changes triggers a cascade of causal-effect processes that may result in irreversible losses in soil biodiversity and in the stability of the trophic webs that sustain soil functions such as N fixation, mineralization of essential nutrients or C stabilization. However, to date, information on the potential impacts of climate-change induced vegetation die-off over soil biodiversity and functioning is fragmented (e.g. case-studies) and not very conclusive. We here want to summarize the state of the knowledge on all potential effects of climate-change induced vegetation die-off over soil biodiversity and soil functioning. Additionally, we also discuss the functional resilience of soils to climate-change vegetation die-off and how management practices could improve the resilience and the sustainability of the soil functioning.

  18. Expectation and Variation with a Virtual Die

    ERIC Educational Resources Information Center

    Watson, Jane; English, Lyn

    2015-01-01

    By the time students reach the middle years they have experienced many chance activities based on dice. Common among these are rolling one die to explore the relationship of frequency and theoretical probability, and rolling two dice and summing the outcomes to consider their probabilities. Although dice may be considered overused by some, the…

  19. The dying child and surviving family members.

    PubMed

    Shrier, D K

    1980-12-01

    This overview of death and dying focuses on the dying child and surviving family members. Children's concepts of death at different developmental stages are reviewed. These range from an inability to distinguish death from other forms of separation prior to age 3, through partial concepts of death until, by age 10 to 15 years, children are able to conceptualize death as universal, inevitable and final. The importance of adults assisting in the child's growing comprehension of death is stressed. The stages of grief and mourning, as outlined by Kubler-Ross, are reviewed from the perspective of the child and family: denial, anger, bargaining, depression and acceptance. Recognition is given to the variations in coping styles among different family members. The special circumstances related to the death of an infant and the impact of the death of a child on the surviving siblings are discussed. Specific helpful interventions to assist families in coping with mourning are described. The death of a child remains one of the most painful and difficult events for a family and its physician to accept.

  20. The Fidelity and Usability of 5-DIE: A Design Study of Enacted Cyberlearning

    ERIC Educational Resources Information Center

    Kern, Cindy L.; Crippen, Kent J.; Skaza, Heather

    2014-01-01

    This paper describes a design study of a cyberlearning instructional unit about climate change created with a new inquiry-based design framework, the 5-featured Dynamic Inquiry Enterprise (5-DIE). The 5-DIE framework was created to address the need for authentic science inquiry experiences in cyberlearning environments that leverage existing tools…

  1. Imagining the Alternatives to Life Prolonging Treatments: Elders' Beliefs about the Dying Experience

    ERIC Educational Resources Information Center

    Winter, Laraine; Parker, Barbara; Schneider, Melissa

    2007-01-01

    Deciding for or against a life-prolonging treatment represents a choice between prolonged life and death. When the death alternative is not described, individuals must supply their own assumptions. How do people imagine the experience of dying? The authors asked 40 elderly people open-ended questions about dying without 4 common life-prolonging…

  2. THE EFFECT OF LASER SHOCK PEENING ON THE LIFE AND FAILURE MODE OF A COLD PILGER DIE

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lavender, Curt A.; Hong, Sung-tae; Smith, Mark T.

    2008-08-11

    The laser shock peening process was used to increase fatigue life of pilger dies made of A2 tool steel by imparting compressive residual stresses to fatigue prone areas of the dies. The result of X-Ray diffraction analysis indicated that deep, high- magnitude compressive residual stresses were generated by the laser shock peening process, and the peened dies exhibited a significant increase of in-service life. Fractography of the failed dies indicates that the fracture mechanism was altered by the peening process.

  3. Physical and Psychological Distress Are Related to Dying Peacefully in Residents With Dementia in Long-Term Care Facilities.

    PubMed

    De Roo, Maaike L; Albers, Gwenda; Deliens, Luc; de Vet, Henrica C W; Francke, Anneke L; Van Den Noortgate, Nele; Van den Block, Lieve

    2015-07-01

    Although dying peacefully is considered an important outcome of high-quality palliative care, large-scale quantitative research on dying peacefully and the factors associated with a peaceful death is lacking. To gain insight into how many residents with dementia in long-term care facilities die peacefully, according to their relatives, and whether that assessment is correlated with observed physical and psychological distress. This was a retrospective cross-sectional study of deceased nursing home residents in a representative sample of long-term care facilities in Flanders, Belgium (2010). Structured post-mortem questionnaires were completed by relatives of the resident, who were asked to what extent they agreed that the resident "appeared to be at peace" during the dying process. Spearman correlation coefficients gave the correlations between physical and psychological distress (as measured using the Symptom Management at the End of Life with Dementia and Comfort Assessment in Dying at the End of Life with Dementia scales) and dying peacefully (as measured using the Quality of Dying in Long Term Care instrument). The sample comprised 92 relatives of deceased residents with dementia. In 54% of cases, relatives indicated that the resident died peacefully. Weak-to-moderate correlations (0.2-0.57) were found between dying peacefully and physical distress in the last week of life. Regarding psychological distress, weak-to-moderate correlations were found for both the last week (0.33-0.44) and last month of life (0.28-0.47). Only half of the residents with dementia died peacefully as perceived by their relatives. Relatives' assessment of whether death was peaceful is related to both physical and psychological distress. Further qualitative research is recommended to gain more in-depth insights into the aspects on which relatives base their judgment of dying peacefully. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All

  4. The Academic Study of Death and Dying.

    ERIC Educational Resources Information Center

    Amend, Edward W.

    The current study of death and dying is an example of constant change and development in academic disciplines. While the discussion of death in time of crisis is hard, if not impossible, youthful undergraduates find this topic to be of considerable interest. For them, a course can be organized effectively as a small and intimate seminar, which…

  5. Dying with Dementia in Long-Term Care

    ERIC Educational Resources Information Center

    Sloane, Philip D.; Zimmerman, Sheryl; Williams, Christianna S.; Hanson, Laura C.

    2008-01-01

    Purpose: To better understand the experiences and potential unmet need of persons who die in long-term care. Design and Methods: We conducted after-death interviews with staff who had cared for 422 decedents with dementia and 159 who were cognitively intact and received terminal care in U.S. nursing homes (NHs) or residential care-assisted living…

  6. [Cervical adaptation of complete cast crowns of various metal alloys, with and without die spacers].

    PubMed

    Stephano, C B; Roselino, R F; Roselino, R B; Campos, G M

    1989-01-01

    A metallic replica from a dental preparation for crown was used to make 8 class-IV stone dies. The wax patterns for the casting of the crowns were obtained in two conditions: a) from the stone die with no spacer; and b) from the stone die with an acrylic spacer. Thus, 64 metallic crowns were casted, using 4 different alloys: DURACAST (Cu-Al), NICROCAST (Ni-Cr) and DURABOND (Ni-Cr), and gold. The casted crowns were fitted in the metallic replica and measured as to the cervical discrepance of fitting. The results showed that the use of die spacers decreases the clinical discrepancies of fitting of the casted crowns (in a statistically significant level), no matter the metallic alloy employed.

  7. Two Decades of Research on Dying: What Do We Know About the Patient?

    ERIC Educational Resources Information Center

    Schultz, Richard; Schlarb, Janet

    1988-01-01

    Reviews literature on terminal patients and nature of their experiences during the time before their death by examining: (1) the number of persons each year who must confront their own death; (2) emotional responses of dying patients to their impending death; (3) interventions for the dying patient; and (4) areas for future research. (Author/NB)

  8. Effect of mold designs on molten metal behaviour in high-pressure die casting

    NASA Astrophysics Data System (ADS)

    Ibrahim, M. D.; Rahman, M. R. A.; Khan, A. A.; Mohamad, M. R.; Suffian, M. S. Z. M.; Yunos, Y. S.; Wong, L. K.; Mohtar, M. Z.

    2017-04-01

    This paper presents a research study conducted in a local automotive component manufacturer that produces aluminium alloy steering housing local and global markets. This study is to investigate the effect of design modification of mold in die casting as to improve the production rate. Design modification is carried out on the casting shot of the mold. Computer flow simulation was carried out to study the flow of molten metal in the mold with respect to the mold design modification. The design parameters of injection speed, die temperature and clamping force has been included in the study. The result of the simulation showed that modifications of casting shot give significant impact towards the molten flow behaviour in casting process. The capabilities and limitations of die casting process simulation to conduct defect analysis had been optimized. This research will enhance the efficiency of the mass production of the industry of die casting with the understanding of defect analysis, which lies on the modification of the mold design, a way early in its stages of production.

  9. The Simulation of Magnesium Wheel Low Pressure Die Casting Based on PAM-CAST™

    NASA Astrophysics Data System (ADS)

    Peng, Yinghong; Wang, Yingchun; Li, Dayong; Zeng, Xiaoqin

    2004-06-01

    Magnesium is the lightest metal commonly used in engineering, with various excellent characteristics such as high strength and electromagnetic interference shielding capability. Particularly, the usage of magnesium in automotive industry can meet better the need to reduce fuel consumption and CO2 emissions. Nowadays, most current magnesium components in automobiles are made by die casting. In this paper, commercial software for die casting, PAM-CAST™, was utilized to simulate the low pressure die casting process of magnesium wheel. Through calculating temperature field and velocity field during filling and solidification stages, the evolution of temperature distribution and liquid fraction was analyzed. Then, the potential defects including the gas entrapments in the middle of the spokes, shrinkages between the rim and the spokes were forecasted. The analytical results revealed that the mold geometry and die casting parameters should be improved in order to get the sound magnesium wheel. The reasons leading to these defects were also analyzed and the solutions to eliminate them were put forward. Furthermore, through reducing the pouring velocity, the air gas entrapments and partial shrinkages were eliminated effectively.

  10. Simulation and experiment of thermal fatigue in the CPV die attach

    NASA Astrophysics Data System (ADS)

    Bosco, Nick; Silverman, Timothy; Kurtz, Sarah

    2012-10-01

    FEM simulation and accelerated thermal cycling have been performed for the CPV die attach. Trends in fatigue damage accumulation and equivalent test time are explored and found to be most sensitive to temperature ramp rate. Die attach crack growth is measured through cycling and found to be in excellent agreement with simulations of the inelastic strain energy accumulated. Simulations of an entire year of weather data provides for the relative ranking of fatigue damage between four cities as well as their equivalent accelerated test time.

  11. Development of a 3D Filling Model of Low-Pressure Die-Cast Aluminum Alloy Wheels

    NASA Astrophysics Data System (ADS)

    Duan, Jianglan; Maijer, Daan; Cockcroft, Steve; Reilly, Carl

    2013-12-01

    A two-phase computational fluid dynamics model of the low-pressure die-cast process for the production of A356 aluminum alloy wheels has been developed to predict the flow conditions during die filling. The filling model represents a 36-deg section of a production wheel, and was developed within the commercial finite-volume package, ANSYS CFX, assuming isothermal conditions. To fully understand the behavior of the free surface, a novel technique was developed to approximate the vent resistances as they impact on the development of a backpressure within the die cavity. The filling model was first validated against experimental data, and then was used to investigate the effects of venting conditions and pressure curves during die filling. It was found that vent resistance and vent location strongly affected die filling time, free surface topography, and air entrainment for a given pressure fill-curve. With regard to the pressure curve, the model revealed a strong relation between the pressure curve and the flow behavior in the hub, which is an area prone to defect formation.

  12. Why Do Cancer Patients Die in the Emergency Department? An Analysis of 283 Deaths in NC EDs

    PubMed Central

    Leak, Ashley; Mayer, Deborah K.; Wyss, Annah; Travers, Debbie; Waller, Anna

    2013-01-01

    Emergency department (ED) visits are made by cancer patients for symptom management, treatment effects, oncologic emergencies, or end of life care. While most patients prefer to die at home, many die in health care institutions. The purpose of this study is to describe visit characteristics of cancer patients who died in the ED and their most common chief complaints using 2008 ED visit data from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT). Of the 37,760 cancer-related ED visits, 283 resulted in death. For lung cancer patients, 104 died in the ED with 70.9% dying on their first ED visit. Research on factors precipitating ED visits by cancer patients is needed to address end of life care needs. PMID:22556288

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

    PubMed

    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.

  14. CAD system of design and engineering provision of die forming of compressor blades for aircraft engines

    NASA Astrophysics Data System (ADS)

    Khaimovich, I. N.

    2017-10-01

    The articles provides the calculation algorithms for blank design and die forming fitting to produce the compressor blades for aircraft engines. The design system proposed in the article allows generating drafts of trimming and reducing dies automatically, leading to significant reduction of work preparation time. The detailed analysis of the blade structural elements features was carried out, the taken limitations and technological solutions allowed forming generalized algorithms of forming parting stamp face over the entire circuit of the engraving for different configurations of die forgings. The author worked out the algorithms and programs to calculate three dimensional point locations describing the configuration of die cavity. As a result the author obtained the generic mathematical model of final die block in the form of three-dimensional array of base points. This model is the base for creation of engineering documentation of technological equipment and means of its control.

  15. Methods and Algorithms for Computer-aided Engineering of Die Tooling of Compressor Blades from Titanium Alloy

    NASA Astrophysics Data System (ADS)

    Khaimovich, A. I.; Khaimovich, I. N.

    2018-01-01

    The articles provides the calculation algorithms for blank design and die forming fitting to produce the compressor blades for aircraft engines. The design system proposed in the article allows generating drafts of trimming and reducing dies automatically, leading to significant reduction of work preparation time. The detailed analysis of the blade structural elements features was carried out, the taken limitations and technological solutions allowed to form generalized algorithms of forming parting stamp face over the entire circuit of the engraving for different configurations of die forgings. The author worked out the algorithms and programs to calculate three dimensional point locations describing the configuration of die cavity.

  16. Results from a new 193nm die-to-database reticle inspection platform

    NASA Astrophysics Data System (ADS)

    Broadbent, William H.; Alles, David S.; Giusti, Michael T.; Kvamme, Damon F.; Shi, Rui-fang; Sousa, Weston L.; Walsh, Robert; Xiong, Yalin

    2010-05-01

    A new 193nm wavelength high resolution reticle defect inspection platform has been developed for both die-to-database and die-to-die inspection modes. In its initial configuration, this innovative platform has been designed to meet the reticle qualification requirements of the IC industry for the 22nm logic and 3xhp memory generations (and shrinks) with planned extensions to the next generation. The 22nm/3xhp IC generation includes advanced 193nm optical lithography using conventional RET, advanced computational lithography, and double patterning. Further, EUV pilot line lithography is beginning. This advanced 193nm inspection platform has world-class performance and the capability to meet these diverse needs in optical and EUV lithography. The architecture of the new 193nm inspection platform is described. Die-to-database inspection results are shown on a variety of reticles from industry sources; these reticles include standard programmed defect test reticles, as well as advanced optical and EUV product and product-like reticles. Results show high sensitivity and low false and nuisance detections on complex optical reticle designs and small feature size EUV reticles. A direct comparison with the existing industry standard 257nm wavelength inspection system shows measurable sensitivity improvement for small feature sizes

  17. Differential die-away analysis system response modeling and detector design

    NASA Astrophysics Data System (ADS)

    Jordan, K. A.; Gozani, T.; Vujic, J.

    2008-05-01

    Differential die-away-analysis (DDAA) is a sensitive technique to detect presence of fissile materials such as 235U and 239Pu. DDAA uses a high-energy (14 MeV) pulsed neutron generator to interrogate a shipping container. The signature is a fast neutron signal hundreds of microseconds after the cessation of the neutron pulse. This fast neutron signal has decay time identical to the thermal neutron diffusion decay time of the inspected cargo. The theoretical aspects of a cargo inspection system based on the differential die-away technique are explored. A detailed mathematical model of the system is developed, and experimental results validating this model are presented.

  18. Reducing the Surface Degradation of Aluminum Extrusion Dies During Preheating

    NASA Astrophysics Data System (ADS)

    Stratton, Paul

    2010-07-01

    Aluminum extrusion dies are usually made from H13 steel that is ferritically nitrocarburized to minimize wear and pick-up. Before being placed in the extrusion press, the dies are preheated to minimize thermal shock at the start of the extrusion cycle. During the preheating time, the nitrocarburized layer oxidizes. Some of this layer can break away during extrusion leaving marks on the product. Although inerting the preheat furnaces with nitrogen has been found to reduce the oxidation, it does not solve the problem completely. Experiments have shown that a small addition of ammonia to the preheating protective atmosphere could eliminate oxidation and prevent nitrogen loss from the surface nitride layer.

  19. Experiences With and Attitudes Toward Death and Dying Among Homeless Persons

    PubMed Central

    Ratner, Edward R; Bartels, Dianne M.; Alderton, Lucy; Hudson, Brenda; Ahluwalia, Jasjit S.

    2007-01-01

    Background Homeless persons face many barriers to health care, have few resources, and experience high death rates. They live lives of disenfranchisement and neglect. Few studies have explored their experiences and attitudes toward death and dying. Unfortunately, studies done in other populations may not apply to homeless persons. Exploring these experiences and attitudes may provide insight into life, health care, and end-of-life (EOL) concerns of this population. Objective To explore the experiences and attitudes toward death and dying among homeless persons. Design Qualitative study utilizing focus groups. Participants Fifty-three homeless persons recruited from homeless service agencies. Measurements In-depth interviews, which were audiotaped and transcribed. Results We present seven themes, some of which are previously unreported. Homeless persons described many significant experiences with death and dying, and many participants suffered losses while very young. These encounters influenced participants’ attitudes toward risks and risky behavior: e.g., for some, these experiences provided justification for high-risk behaviors and influenced their behaviors while living on the streets. For others, they may be associated with their homelessness. Finally, these experiences informed their attitudes toward death and dying as well as EOL care; homeless persons believe that care will be poor at the EOL. Conclusions Findings from this study have implications for addressing social services, health promotion, prevention, and EOL care for homeless persons, as well as for others who are poor and disenfranchised. PMID:17372788

  20. Does the internet change how we die and mourn? Overview and analysis.

    PubMed

    Walter, Tony; Hourizi, Rachid; Moncur, Wendy; Pitsillides, Stacey

    The article outlines the issues that the internet presents to death studies. Part 1 describes a range of online practices that may affect dying, the funeral, grief and memorialization, inheritance and archaeology; it also summarizes the kinds of research that have been done in these fields. Part 2 argues that these new online practices have implications for, and may be illuminated by, key concepts in death studies: the sequestration (or separation from everyday life) of death and dying, disenfranchisement of grief, private grief, social death, illness and grief narratives, continuing bonds with the dead, and the presence of the dead in society. In particular, social network sites can bring dying and grieving out of both the private and public realms and into the everyday life of social networks beyond the immediate family, and provide an audience for once private communications with the dead.

  1. Ageless Aluminum-Cerium-Based Alloys in High-Volume Die Casting for Improved Energy Efficiency

    DOE PAGES

    Stromme, Eric T.; Henderson, Hunter B.; Sims, Zachary C.; ...

    2018-04-25

    Strong chemical reactions between Al and Ce lead to the formation of intermetallics with exceptional thermal stability. The rapid formation of intermetallics directly from the liquid phase during solidification of Al-Ce alloys leads to an ultrafine microconstituent structure that effectively strengthens as-cast alloys without further microstructural optimization via thermal processing. Die casting is a high-volume manufacturing technology that accounts for greater than 40% of all cast Al products, whereas Ce is highly overproduced as a waste product of other rare earth element (REE) mining. Reducing heat treatments would stimulate significant improvements in manufacturing energy efficiency, exceeding (megatonnes/year) per large-scale heat-treatmentmore » line. In this study, multiple compositions were evaluated with wedge mold castings to test the sensitivity of alloys to the variable solidification rate inherent in high-pressure die casting. Once a suitable composition was determined, it was successfully demonstrated at 800 lbs/h in a 600-ton die caster, after which the as-die cast parts performed similarly to ubiquitous A380 in the same geometry without requiring heat treatment. Furthermore, this work demonstrates the compatibility of Al REE alloys with high-volume die-casting applications with minimal heat treatments.« less

  2. Ageless Aluminum-Cerium-Based Alloys in High-Volume Die Casting for Improved Energy Efficiency

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Stromme, Eric T.; Henderson, Hunter B.; Sims, Zachary C.

    Strong chemical reactions between Al and Ce lead to the formation of intermetallics with exceptional thermal stability. The rapid formation of intermetallics directly from the liquid phase during solidification of Al-Ce alloys leads to an ultrafine microconstituent structure that effectively strengthens as-cast alloys without further microstructural optimization via thermal processing. Die casting is a high-volume manufacturing technology that accounts for greater than 40% of all cast Al products, whereas Ce is highly overproduced as a waste product of other rare earth element (REE) mining. Reducing heat treatments would stimulate significant improvements in manufacturing energy efficiency, exceeding (megatonnes/year) per large-scale heat-treatmentmore » line. In this study, multiple compositions were evaluated with wedge mold castings to test the sensitivity of alloys to the variable solidification rate inherent in high-pressure die casting. Once a suitable composition was determined, it was successfully demonstrated at 800 lbs/h in a 600-ton die caster, after which the as-die cast parts performed similarly to ubiquitous A380 in the same geometry without requiring heat treatment. Furthermore, this work demonstrates the compatibility of Al REE alloys with high-volume die-casting applications with minimal heat treatments.« less

  3. A framework for development of an intelligent system for design and manufacturing of stamping dies

    NASA Astrophysics Data System (ADS)

    Hussein, H. M. A.; Kumar, S.

    2014-07-01

    An integration of computer aided design (CAD), computer aided process planning (CAPP) and computer aided manufacturing (CAM) is required for development of an intelligent system to design and manufacture stamping dies in sheet metal industries. In this paper, a framework for development of an intelligent system for design and manufacturing of stamping dies is proposed. In the proposed framework, the intelligent system is structured in form of various expert system modules for different activities of design and manufacturing of dies. All system modules are integrated with each other. The proposed system takes its input in form of a CAD file of sheet metal part, and then system modules automate all tasks related to design and manufacturing of stamping dies. Modules are coded using Visual Basic (VB) and developed on the platform of AutoCAD software.

  4. Improving Attitudes and Perceived Competence in Caring for Dying Patients: An End-of-Life Simulation.

    PubMed

    Lippe, Megan Pfitzinger; Becker, Heather

    2015-01-01

    The aim of this study was to assess learning outcomes from a simulation on providing care to a critically ill patient from whom care is ultimately withdrawn. Nursing students have anxiety and low perceived competence for caring for dying patients. Effective strategies for teaching communication, assessment, and basic nursing skills are needed. A pretest-posttest design compared perceived competence and attitudes in caring for dying patients with three separate cohorts of undergraduate nursing students performing the simulation. The cohorts had significantly improved scores on the perceived competence (p < .001) and attitude (p < .01) measures following the simulation. Reliability for a new instrument to assess perceived competence in caring for dying patients was also established. This study's simulation offers a robust teaching strategy for improving nursing students' attitudes and perceived competence in caring for dying patients.

  5. LED Die-Bonded on the Ag/Cu Substrate by a Sn-BiZn-Sn Bonding System

    NASA Astrophysics Data System (ADS)

    Tang, Y. K.; Hsu, Y. C.; Lin, E. J.; Hu, Y. J.; Liu, C. Y.

    2016-12-01

    In this study, light emitting diode (LED) chips were die-bonded on a Ag/Cu substrate by a Sn-BixZn-Sn bonding system. A high die-bonding strength is successfully achieved by using a Sn-BixZn-Sn ternary system. At the bonding interface, there is observed a Bi-segregation phenomenon. This Bi-segregation phenomenon solves the problems of the brittle layer-type Bi at the joint interface. Our shear test results show that the bonding interface with Bi-segregation enhances the shear strength of the LED die-bonding joints. The Bi-0.3Zn and Bi-0.5Zn die-bonding cases have the best shear strength among all die-bonding systems. In addition, we investigate the atomic depth profile of the deposited Bi-xZn layer by evaporating Bi-xZn E-gun alloy sources. The initial Zn content of the deposited Bi-Zn alloy layers are much higher than the average Zn content in the deposited Bi-Zn layers.

  6. How inverse solver technologies can support die face development and process planning in the automotive industry

    NASA Astrophysics Data System (ADS)

    Huhn, Stefan; Peeling, Derek; Burkart, Maximilian

    2017-10-01

    With the availability of die face design tools and incremental solver technologies to provide detailed forming feasibility results in a timely fashion, the use of inverse solver technologies and resulting process improvements during the product development process of stamped parts often is underestimated. This paper presents some applications of inverse technologies that are currently used in the automotive industry to streamline the product development process and greatly increase the quality of a developed process and the resulting product. The first focus is on the so-called target strain technology. Application examples will show how inverse forming analysis can be applied to support the process engineer during the development of a die face geometry for Class `A' panels. The drawing process is greatly affected by the die face design and the process designer has to ensure that the resulting drawn panel will meet specific requirements regarding surface quality and a minimum strain distribution to ensure dent resistance. The target strain technology provides almost immediate feedback to the process engineer during the die face design process if a specific change of the die face design will help to achieve these specific requirements or will be counterproductive. The paper will further show how an optimization of the material flow can be achieved through the use of a newly developed technology called Sculptured Die Face (SDF). The die face generation in SDF is more suited to be used in optimization loops than any other conventional die face design technology based on cross section design. A second focus in this paper is on the use of inverse solver technologies for secondary forming operations. The paper will show how the application of inverse technology can be used to accurately and quickly develop trim lines on simple as well as on complex support geometries.

  7. Oregon's experience with aid in dying: findings from the death with dignity laboratory.

    PubMed

    Coombs Lee, Barbara

    2014-11-01

    With passage of the Death with Dignity Act in 1994, Oregon became the first jurisdiction to authorize and regulate aid in dying. Data from that experience are comprehensive and bountiful, and answer a multitude of questions and concerns about whether the benefits of recognizing the medical practice of aid in dying justify the risks. An exhaustive description of findings from Oregon's aid-in-dying experience is beyond the scope of this or any single article on the subject. This article provides a summary of data highlights, gleaned from scientific investigations and governmental reporting. It organizes highlighted reports along subjects so that readers may see what various sources have to teach on a number of questions important to policy makers. © 2014 New York Academy of Sciences.

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

    PubMed

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

    2016-01-01

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

  9. Dying or living?: The double bind.

    PubMed

    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.

  10. Prediction of Thermal Fatigue in Tooling for Die-casting Copper via Finite Element Analysis

    NASA Astrophysics Data System (ADS)

    Sakhuja, Amit; Brevick, Jerald R.

    2004-06-01

    Recent research by the Copper Development Association (CDA) has demonstrated the feasibility of die-casting electric motor rotors using copper. Electric motors using copper rotors are significantly more energy efficient relative to motors using aluminum rotors. However, one of the challenges in copper rotor die-casting is low tool life. Experiments have shown that the higher molten metal temperature of copper (1085 °C), as compared to aluminum (660 °C) accelerates the onset of thermal fatigue or heat checking in traditional H-13 tool steel. This happens primarily because the mechanical properties of H-13 tool steel decrease significantly above 650 °C. Potential approaches to mitigate the heat checking problem include: 1) identification of potential tool materials having better high temperature mechanical properties than H-13, and 2) reduction of the magnitude of cyclic thermal excursions experienced by the tooling by increasing the bulk die temperature. A preliminary assessment of alternative tool materials has led to the selection of nickel-based alloys Haynes 230 and Inconel 617 as potential candidates. These alloys were selected based on their elevated temperature physical and mechanical properties. Therefore, the overall objective of this research work was to predict the number of copper rotor die-casting cycles to the onset of heat checking (tool life) as a function of bulk die temperature (up to 650 °C) for Haynes 230 and Inconel 617 alloys. To achieve these goals, a 2D thermo-mechanical FEA was performed to evaluate strain ranges on selected die surfaces. The method of Universal Slopes (Strain Life Method) was then employed for thermal fatigue life predictions.

  11. Preventive Therapy with Siblings of a Dying Child.

    ERIC Educational Resources Information Center

    Feinberg, Daniel

    A case study of psychiatric intervention for two sisters whose brother is dying of leukemia is presented. The therapeutic technique attempted to deal with the threatened loss by a forthright approach to the reality situation, encouraging "immunizing" discussions, allowance for catharsis without severe regression, emphasis on reality orientation,…

  12. You can only die thrice: death and dying of a human body in psychoanalytical perspective.

    PubMed

    Sterk, Karmen

    2010-12-01

    This paper compares the (cultural) necessity of death/dying, perceived as a sequence of Imaginary--Real--Symbolic, to Van Gennep's three-staged rite of passage. If this logic is disrupted, the subject responsible necessitates attribution of special social status and can come to embody the imagery of a life worth living. This philosophical framework, which includes epistemologies borrowed from medical anthropology, demonstrates there is more for humans to lose than biological (Real) life; a far greater loss is to exist without (Symbolic) reason to live. A critique of prevalent quantitative methodology in assessing links between spirituality and the human body is added.

  13. An investigation on die crack detection using Temperature Sensitive Parameter for high speed LED mass production

    NASA Astrophysics Data System (ADS)

    Annaniah, Luruthudass; Devarajan, Mutharasu; San, Teoh Kok

    To ensure the highest quality & long-term reliability of LED components it is necessary to examine LED dice that have sustained mechanical damage during the manufacturing process. This paper has demonstrated that detection of die crack in mass manufactured LEDs can be achieved by measuring Temperature Sensitive Parameters (TSPs) during final testing. A newly-designed apparatus and microcontroller was used for this investigation in order to achieve the millisecond switching time needed for detecting thermal transient effects and at the same time meet the expected speed for mass manufacturing. Evaluations conducted at lab scale shows that thermal transient behaviour of cracked die is significantly different than that of an undamaged die. Having an established test limits to differentiate cracked dice, large volume tests in a production environment were used to confirm the effectiveness of this test method. Failure Bin Analysis (FBA) of this high volume experiment confirmed that all the cracked die LEDs were detected and the undamaged LEDs passed this test without over-rejection. The work verifies that tests based on TSP are effective in identifying die cracks and it is believed that the method could be extended to other types of rejects that have thermal transient signatures such as die delamination.

  14. Metallographic assessment of Al-12Si high-pressure die casting escalator steps.

    PubMed

    Vander Voort, George Frederic; Suárez-Peña, Beatriz; Asensio-Lozano, Juan

    2014-10-01

    A microstructural characterization study was performed on high-pressure die cast specimens extracted from escalator steps manufactured from an Al-12 wt.% Si alloy designed for structural applications. Black and white, color light optical imaging and scanning electron microscopy techniques were used to conduct the microstructural analysis. Most regions in the samples studied contained globular-rosette primary α-Al grains surrounded by an Al-Si eutectic aggregate, while primary dendritic α-Al grains were present in the surface layer. This dendritic microstructure was observed in the regions where the melt did not impinge directly on the die surface during cavity filling. Consequently, microstructures in the surface layer were nonuniform. Utilizing physical metallurgy principles, these results were analyzed in terms of the applied pressure and filling velocity during high-pressure die casting. The effects of these parameters on solidification at different locations of the casting are discussed.

  15. Telemedicine’s Potential to Support Good Dying in Nigeria: A Qualitative Study

    PubMed Central

    van Gurp, Jelle; Soyannwo, Olaitan; Odebunmi, Kehinde; Dania, Simpa; van Selm, Martine; van Leeuwen, Evert; Vissers, Kris; Hasselaar, Jeroen

    2015-01-01

    Objectives This qualitative study explores Nigerian health care professionals’ concepts of good dying/a good death and how telemedicine technologies and services would fit the current Nigerian palliative care practice. Materials and Methods Supported by the Centre for Palliative Care Nigeria (CPCN) and the University College Hospital (UCH) in Ibadan, Nigeria, the authors organized three focus groups with Nigerian health care professionals interested in palliative care, unstructured interviews with key role players for palliative care and representatives of telecom companies, and field visits to primary, secondary and tertiary healthcare clinics that provided palliative care. Data analysis consisted of open coding, constant comparison, diagramming of categorizations and relations, and extensive member checks. Results The focus group participants classified good dying into 2 domains: a feeling of completion of the individual life and dying within the community. Reported barriers to palliative care provision were socio-economic consequences of being seriously ill, taboos on dying and being ill, restricted access to adequate medical–technical care, equation of religion with medicine, and the faulty implementation of palliative care policy by government. The addition of telemedicine to Nigeria’s palliative care practice appears problematic, due to irregular bandwidth, poor network coverage, and unstable power supply obstructing interactivity and access to information. However, a tele-education ‘lite’ scenario seemed viable in Nigeria, wherein low-tech educational networks are central that build on non-synchronous online communication. Discussion Nigerian health care professionals’ concepts on good dying/a good death and barriers and opportunities for palliative care provision were, for the greater part, similar to prior findings from other studies in Africa. Information for and education of patient, family, and community are essential to further improve

  16. Hospice Use and High-Intensity Care in Men Dying of Prostate Cancer

    PubMed Central

    Bergman, Jonathan; Saigal, Christopher S.; Lorenz, Karl A.; Hanley, Janet; Miller, David C.; Gore, John L.; Litwin, Mark S.

    2012-01-01

    Background Hospice programs improve the quality of life and quality of death for men dying of cancer. We sought to characterize hospice use by men dying of prostate cancer and to compare the use of high-intensity care between those who did or did not enroll in hospice. Methods We used linked Surveillance, Epidemiology, and End Results–Medicare data to identify a cohort of Medicare beneficiaries who died of prostate cancer between 1992 and 2005. We created 2 multivariable logistic regression models, one to identify factors associated with hospice use and one to determine the association of hospice use with the receipt of diagnostic and interventional procedures and physician visits at the end of life. Results Of 14 521 men dying of prostate cancer, 7646 (53%) used hospice for a median of 24 days. Multivariable modeling demonstrated that African American ethnicity (odds ratio [OR], 0.78; 95% confidence interval [CI], 0.68–0.88) and higher Charlson comorbidity index (OR, 0.49; 95% CI, 0.44–0.55) were associated with lower odds of hospice use, while having a partner (OR, 1.23; 95% CI, 1.14–1.32) and more recent year of death (OR, 1.12; 95% CI, 1.11–1.14) were associated with higher odds of hospice use. Men dying of prostate cancer who enrolled in hospice were less likely (OR, 0.82; 95% CI, 0.74–0.91) to receive high-intensity care, including intensive care unit admissions, inpatient stays, and multiple emergency department visits. Conclusions The proportion of individuals using hospice is increasing, but the timing of hospice referral remains poor. Those who enroll in hospice are less likely to receive high-intensity end-of-life care. PMID:20937914

  17. Perovskite solar cells in N-I-P structure with four slot-die-coated layers

    PubMed Central

    Burkitt, Daniel; Searle, Justin

    2018-01-01

    The fabrication of perovskite solar cells in an N-I-P structure with compact titanium dioxide blocking, mesoporous titanium dioxide scaffold, single-step perovskite and hole-transport layers deposited using the slot-die coating technique is reported. Devices on fluorine-doped tin oxide-coated glass substrates with evaporated gold top contacts and four slot-die-coated layers are demonstrated, and best cells reach stabilized power conversion efficiencies of 7%. This work demonstrates the suitability of slot-die coating for the production of layers within this perovskite solar cell stack and the potential to transfer to large area and roll-to-roll manufacturing processes. PMID:29892402

  18. Energy Saving Melting and Revert Reduction Technology: Melting Efficiency in Die Casting Operations

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    David Schwam

    2012-12-15

    This project addressed multiple aspects of the aluminum melting and handling in die casting operations, with the objective of increasing the energy efficiency while improving the quality of the molten metal. The efficiency of melting has always played an important role in the profitability of aluminum die casting operations. Consequently, die casters need to make careful choices in selecting and operating melting equipment and procedures. The capital cost of new melting equipment with higher efficiency can sometimes be recovered relatively fast when it replaces old melting equipment with lower efficiency. Upgrades designed to improve energy efficiency of existing equipment maymore » be well justified. Energy efficiency is however not the only factor in optimizing melting operations. Melt losses and metal quality are also very important. Selection of melting equipment has to take into consideration the specific conditions at the die casting shop such as availability of floor space, average quantity of metal used as well as the ability to supply more metal during peaks in demand. In all these cases, it is essential to make informed decisions based on the best available data.« less

  19. Field results from a new die-to-database reticle inspection platform

    NASA Astrophysics Data System (ADS)

    Broadbent, William; Yokoyama, Ichiro; Yu, Paul; Seki, Kazunori; Nomura, Ryohei; Schmalfuss, Heiko; Heumann, Jan; Sier, Jean-Paul

    2007-05-01

    A new die-to-database high-resolution reticle defect inspection platform, TeraScanHR, has been developed for advanced production use with the 45nm logic node, and extendable for development use with the 32nm node (also the comparable memory nodes). These nodes will use predominantly ArF immersion lithography although EUV may also be used. According to recent surveys, the predominant reticle types for the 45nm node are 6% simple tri-tone and COG. Other advanced reticle types may also be used for these nodes including: dark field alternating, Mask Enhancer, complex tri-tone, high transmission, CPL, etc. Finally, aggressive model based OPC will typically be used which will include many small structures such as jogs, serifs, and SRAF (sub-resolution assist features) with accompanying very small gaps between adjacent structures. The current generation of inspection systems is inadequate to meet these requirements. The architecture and performance of the new TeraScanHR reticle inspection platform is described. This new platform is designed to inspect the aforementioned reticle types in die-to-database and die-to-die modes using both transmitted and reflected illumination. Recent results from field testing at two of the three beta sites are shown (Toppan Printing in Japan and the Advanced Mask Technology Center in Germany). The results include applicable programmed defect test reticles and advanced 45nm product reticles (also comparable memory reticles). The results show high sensitivity and low false detections being achieved. The platform can also be configured for the current 65nm, 90nm, and 130nm nodes.

  20. Length of home hospice care, family-perceived timing of referrals, perceived quality of care, and quality of death and dying in terminally ill cancer patients who died at home.

    PubMed

    Yamagishi, Akemi; Morita, Tatsuya; Kawagoe, Shohei; Shimizu, Megumi; Ozawa, Taketoshi; An, Emi; Kobayakawa, Makoto; Tsuneto, Satoru; Shima, Yasuo; Miyashita, Mitsunori

    2015-02-01

    This study aims to clarify the length of home hospice care, family-perceived timing of referrals, and their effects on the family-perceived quality of care and quality of death and dying of terminally ill cancer patients who died at home and identify the determinants of perceived late referrals. A multicenter questionnaire survey was conducted involving 1,052 family members of cancer patients who died at home supported by 15 home-based hospice services throughout Japan. A total of 693 responses were analyzed (effective response rate, 66 %). Patients received home-based hospice care for a median of 35.0 days, and 8.0 % received home hospice care for less than 1 week. While 1.5 % of the families reported the timing of referrals as early, 42 % reported the timing as late or too late. The families of patients with a length of care of less than 4 weeks were more likely to regard the timing of referrals as late or too late. The patients of family members who regarded the timing of referrals as late or too late had a significantly lower perceived quality of care (effect size, 0.18; P = 0.039) and lower quality of death and dying (effect size, 0.15, P = 0.063). Independent determinants of higher likelihoods of perceived late referrals included: frequent visits to emergency departments, patient being unprepared for worsening condition, and patient having concerns about relationship with new doctor. Discharge nurse availability was independently associated with lower likelihoods of perceived late referrals. A significant number of bereaved families regarded the timing of referrals to home hospices as late, and the perceived timing was associated with the family-perceived quality of care and quality of death and dying. Systematic strategies to overcome the barriers related to perceived late referrals are necessary.

  1. MICROORGANISMS DIE-OFF RATES IN URBAN STORMWATER RUNOFF 2007

    EPA Science Inventory

    Stormwater best management practices (BMPs) are often considered effective tools to mitigate the effects of stormwater pollutants before they are discharged to receiving waters. However, BMP performance for microorganisms removal is not well documented. Microorganisms die-off in ...

  2. MICROORGANISMS DIE-OFF RATES IN URBAN STORMWATER RUNOFF 2007

    EPA Science Inventory

    Stormwater best management practices (BMPs) are often considered effective tools to mitigate the effects of stormwater pollutants before they are discharged to receiving waters. However, BMP performance for microorganisms removal is not well documented. Microorganisms die-off in...

  3. Ars Moriendi; the art of dying well - new insights into the molecular pathways of necroptotic cell death.

    PubMed

    Murphy, James M; Silke, John

    2014-02-01

    When our time comes to die most people would probably opt for a quick, peaceful and painless exit. But the manner and timing are rarely under our direct control. Hence the Ars moriendi, literally, "The Art of Dying", two texts written in Latin around the 15th century that offered advice on how to die well according to the Christian ideals of the time. In contrast, for individual cells, the death process is frequently under their control and several signaling pathways that cause cell death, including apoptosis, pyroptosis and necroptosis, have been described. Furthermore the manner in which cells die can have good or bad consequences for the organism. In this review we will discuss how cells die via the necroptotic signaling pathway, with emphasis on recent structural work and place this work in a biological context by discussing relevant studies with knock-out animals.

  4. Exploring the concept of quality care for the person who is dying.

    PubMed

    Stefanou, Nichola; Faircloth, Sandra

    2010-12-01

    The concept of good quality care for the patient who is dying is diverse and complex. Many of the actions that are being taken to increase the quality of care of the dying patient are based around outcome, uniformity of service and standardization of process. There are two main areas that are referred to when dealing with care of the dying patient; end-of-life care and palliative care. High quality end-of-life care is increasingly recognized as an ethical obligation of health-care providers, clinicians and organizations, and yet there appears little evidence from the patients' perspective. There are many national and local initiatives taking place to improve the quality of care people receive towards the end of their life. This being said initiatives alone will not achieve good quality care and deliver good patient experiences. Only clinicians working at the front line can truly influence the way in which quality is improved and good experiences delivered.

  5. Challenges Facing a Deaf Family Member Concerning a Loved One’s Dying

    PubMed Central

    Kehl, Karen A.; Gartner, Constance M.

    2010-01-01

    Individuals who are Deaf face challenges both similar and unique from those faced by hearing individuals when a family member is dying. This study was guided by the question “What are the challenges faced by a Deaf family member when a loved one is dying?” Methods - This qualitative study is guided by critical theory and an interpretive perspective. Robert, a college-educated older adult who has been Deaf from birth was interviewed in American Sign Language using a death history format. Results – There are challenges for Deaf family members that affect communication with both the dying person and health care professionals. Patient-family communication issues included physical challenges and financial challenges. Lack of cultural competence concerning the Deaf community created challenges communicating with professionals. Decision-making was also a challenge. Conclusions These findings provide a framework for future research concerning the needs of Deaf individuals facing the end of life and provide guidance for clinicians. PMID:19910395

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

    PubMed

    Gates, M F

    1991-01-01

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

  7. The Conjugation-Specific Die5 Protein Is Required for Development of the Somatic Nucleus in both Paramecium and Tetrahymena▿

    PubMed Central

    Matsuda, Atsushi; Shieh, Annie Wan-Yi; Chalker, Douglas L.; Forney, James D.

    2010-01-01

    Development in ciliated protozoa involves extensive genome reorganization within differentiating macronuclei, which shapes the somatic genome of the next vegetative generation. Major events of macronuclear differentiation include excision of internal eliminated sequences (IESs), chromosome fragmentation, and genome amplification. Proteins required for these events include those with homology throughout eukaryotes as well as proteins apparently unique to ciliates. In this study, we identified the ciliate-specific Defective in IES Excision 5 (DIE5) genes of Paramecium tetraurelia (PtDIE5) and Tetrahymena thermophila (TtDIE5) as orthologs that encode nuclear proteins expressed exclusively during development. Abrogation of PtDie5 protein (PtDie5p) function by RNA interference (RNAi)-mediated silencing or TtDie5p by gene disruption resulted in the failure of developing macronuclei to differentiate into new somatic nuclei. Tetrahymena ΔDIE5 cells arrested late in development and failed to complete genome amplification, whereas RNAi-treated Paramecium cells highly amplified new macronuclear DNA before the failure in differentiation, findings that highlight clear differences in the biology of these distantly related species. Nevertheless, IES excision and chromosome fragmentation failed to occur in either ciliate, which strongly supports that Die5p is a critical player in these processes. In Tetrahymena, loss of zygotic expression during development was sufficient to block nuclear differentiation. This observation, together with the finding that knockdown of Die5p in Paramecium still allows genome amplification, indicates that this protein acts late in macronuclear development. Even though DNA rearrangements in these two ciliates look to be quite distinct, analysis of DIE5 establishes the action of a conserved mechanism within the genome reorganization pathway. PMID:20495055

  8. The conjugation-specific Die5 protein is required for development of the somatic nucleus in both Paramecium and Tetrahymena.

    PubMed

    Matsuda, Atsushi; Shieh, Annie Wan-Yi; Chalker, Douglas L; Forney, James D

    2010-07-01

    Development in ciliated protozoa involves extensive genome reorganization within differentiating macronuclei, which shapes the somatic genome of the next vegetative generation. Major events of macronuclear differentiation include excision of internal eliminated sequences (IESs), chromosome fragmentation, and genome amplification. Proteins required for these events include those with homology throughout eukaryotes as well as proteins apparently unique to ciliates. In this study, we identified the ciliate-specific Defective in IES Excision 5 (DIE5) genes of Paramecium tetraurelia (PtDIE5) and Tetrahymena thermophila (TtDIE5) as orthologs that encode nuclear proteins expressed exclusively during development. Abrogation of PtDie5 protein (PtDie5p) function by RNA interference (RNAi)-mediated silencing or TtDie5p by gene disruption resulted in the failure of developing macronuclei to differentiate into new somatic nuclei. Tetrahymena DeltaDIE5 cells arrested late in development and failed to complete genome amplification, whereas RNAi-treated Paramecium cells highly amplified new macronuclear DNA before the failure in differentiation, findings that highlight clear differences in the biology of these distantly related species. Nevertheless, IES excision and chromosome fragmentation failed to occur in either ciliate, which strongly supports that Die5p is a critical player in these processes. In Tetrahymena, loss of zygotic expression during development was sufficient to block nuclear differentiation. This observation, together with the finding that knockdown of Die5p in Paramecium still allows genome amplification, indicates that this protein acts late in macronuclear development. Even though DNA rearrangements in these two ciliates look to be quite distinct, analysis of DIE5 establishes the action of a conserved mechanism within the genome reorganization pathway.

  9. 25 CFR 304.5 - Dies to identify tribe.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Dies to identify tribe. 304.5 Section 304.5 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER, USE OF... used where the marker is a Navajo Indian; similarly, for Zuni, Hopi, and Rio Grande Pueblo. ...

  10. Attitudes towards assisted dying are influenced by question wording and order: a survey experiment.

    PubMed

    Magelssen, Morten; Supphellen, Magne; Nortvedt, Per; Materstvedt, Lars Johan

    2016-04-27

    Surveys on attitudes towards assisted dying play an important role in informing public debate, policy and legislation. Unfortunately, surveys are often designed with insufficient attention to framing effects; that is, effects on the respondents' stated attitudes caused by question wording and context. The purpose of this study was to demonstrate and measure such framing effects. Survey experiment in which an eight-question survey on attitudes towards assisted dying was distributed to Norwegian citizens through a web-based panel. Two variations of question wording as well as two variations of question order were employed. Respondents were randomized to receive one of four questionnaire versions. Three thousand and fifty responses were received. There were moderate to large question wording and question order effects. A majority of Norwegian citizens favour the legalization of assisted dying for patients with terminal or chronic disease. Stakeholders in the assisted dying debate need to acknowledge potential framing effects, and accordingly should interpret survey results with caution. The same holds for researchers who conduct attitude surveys in the field of bioethics.

  11. Coping with Dying: Lessons That We Should and Should Not Learn from the Work of Elisabeth Kubler-Ross.

    ERIC Educational Resources Information Center

    Corr, Charles A.

    1993-01-01

    Appraises work of Elisabeth Kubler-Ross in area of coping with dying. Suggests lessons from that work. Draws broad conclusions about processes involved in coping with dying, argues on behalf of need to develop better theoretical models to explicate what is involved in coping with dying, and suggests requirements for model. (Author/NB)

  12. Klamath River Basin Hydrologic Conditions Prior to the September 2002 Die-Off of Salmon and Steelhead

    USGS Publications Warehouse

    Lynch, Dennis D.; Risley, John C.

    2003-05-27

    This report characterizes streamflow and water temperature conditions during the period leading up to the die-off and compares them to historical conditions in the Klamath River. This report is not an exploration of the causative mechanism of the die-off; rather, it is intended to provide detailed documentation of these conditions to be used by those examining the cause(s) of the die-off and to provide information that can contribute to decisions about future water management in the Klamath Basin.

  13. Dying means suffocating: perceptions of people living with severe COPD facing the end of life.

    PubMed

    Hall, Sylvie; Legault, Alan; Côté, José

    2010-09-01

    The purpose of this research was to describe the perceptions of people living with severe chronic obstructive pulmonary disease (COPD) with respect to the end of life. For this descriptive exploratory qualitative study, semi-structured interviews were conducted with six participants suffering from severe COPD hospitalized in the past year following an exacerbation episode. The data were analyzed using the method developed by Miles and Huberman (2003), which comprises three main steps: data reduction, data display, and conclusion drawing/verification. The analysis yielded four themes that reflect the perceptions of participants with respect to the end of life, namely: living and seeing oneself decline, living and preparing to die, dying of COPD means suffocating, and dying in hospital surrounded by family and friends. What emerges from the study is that persons living with severe COPD wish to die without suffocating, in hospital, surrounded by family and friends, all the while hoping to go on living. This study contributes to a more comprehensive understanding of the end-of-life experience. It shows the importance of accompanying these persons properly towards the end of life and at the moment of dying. The study proposes a series of avenues for future research and makes recommendations for practice.

  14. Parallel processing of embossing dies with ultrafast lasers

    NASA Astrophysics Data System (ADS)

    Jarczynski, Manfred; Mitra, Thomas; Brüning, Stephan; Du, Keming; Jenke, Gerald

    2018-02-01

    Functionalization of surfaces equips products and components with new features like hydrophilic behavior, adjustable gloss level, light management properties, etc. Small feature sizes demand diffraction-limited spots and adapted fluence for different materials. Through the availability of high power fast repeating ultrashort pulsed lasers and efficient optical processing heads delivering diffraction-limited small spot size of around 10μm it is feasible to achieve fluences higher than an adequate patterning requires. Hence, parallel processing is becoming of interest to increase the throughput and allow mass production of micro machined surfaces. The first step on the roadmap of parallel processing for cylinder embossing dies was realized with an eight- spot processing head based on ns-fiber laser with passive optical beam splitting, individual spot switching by acousto optical modulation and an advanced imaging. Patterning of cylindrical embossing dies shows a high efficiency of nearby 80%, diffraction-limited and equally spaced spots with pitches down to 25μm achieved by a compression using cascaded prism arrays. Due to the nanoseconds laser pulses the ablation shows the typical surrounding material deposition of a hot process. In the next step the processing head was adapted to a picosecond-laser source and the 500W fiber laser was replaced by an ultrashort pulsed laser with 300W, 12ps and a repetition frequency of up to 6MHz. This paper presents details about the processing head design and the analysis of ablation rates and patterns on steel, copper and brass dies. Furthermore, it gives an outlook on scaling the parallel processing head from eight to 16 individually switched beamlets to increase processing throughput and optimized utilization of the available ultrashort pulsed laser energy.

  15. Cancer patient autonomy and quality of dying-a prospective nationwide survey in Taiwan.

    PubMed

    Cheng, Shao-Yi; Lin, Wen-Yuan; Cheng, Ya-Hui; Huang, Chien Hsiun; Chen, Ching-Yu; Hwang, Shinn-Jang; Tsai, Shih-Tzu; Chiu, Tai-Yuan

    2016-02-01

    Patient autonomy is an essential factor in the measurement of quality of dying. We aimed to conduct a study to investigate the factors affecting the autonomy of advanced cancer patients in Taiwan. We conducted a prospective, multicenter study and recruited 574 advanced cancer patients from four inpatient hospice wards in Taiwan; their quality of dying was measured using the validated good death scale and the audit scale. Physician-assessed autonomy and the other scales were measured in a team conference by the primary care physician and the team 1 week after the patient had passed away. The good death scale was measured twice, once at admission and then after the patient had passed away for comparison. We measured factors affecting the improvement in quality of dying of these patients initially by applying multiple linear regression analysis. Then, taking physician-assessed autonomy as a dependent variable, we identified the factors that affected this variable. The good death score at admission, clear consciousness, number of admission days beyond 7, better physical care, higher physician-assessed autonomy, better emotional support, better communication, better continuity of life, and physician-reported rate of closure were factors affecting the quality of dying. Further analysis identified age (p = 0.031), consciousness (p = 0.01), and total good death scale score at death (p < 0.001) as determinants of physician-assessed autonomy. We concluded that physician-assessed autonomy would affect a good death and was highly correlated with age, consciousness level, and quality of dying at the end for advanced cancer patients in Taiwan. Copyright © 2015 John Wiley & Sons, Ltd.

  16. A Study on Segmented Multiple-Step Forming of Doubly Curved Thick Plate by Reconfigurable Multi-Punch Dies

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ko, Young Ho; Han, Myoung Soo; Han, Jong Man

    2007-05-17

    Doubly curved thick plate forming in shipbuilding industries is currently performed by a thermal forming process, called as Line Heating by using gas flame torches. Due to the empirical manual work of it, the industries are eager for an alternative way to manufacture curved thick plates for ships. It was envisaged in this study to manufacture doubly curved thick plates by the multi-punch die forming. Experiments and finite element analyses were conducted to evaluate the feasibility of the reconfigurable discrete die forming to the thick plates. Single and segmented multiple step forming procedures were considered from both forming efficiency andmore » accuracy. Configuration of the multi-punch dies suitable for the segmented multiple step forming was also explored. As a result, Segmented multiple step forming with matched dies had a limited formability when the objective shapes become complicate, while a unmatched die configuration provided better possibility to manufacture large curved plates for ships.« less

  17. Hubble Finds an Hourglass Nebula around a Dying Star

    NASA Image and Video Library

    1996-01-16

    This Hubble telescope snapshot of MyCn18, a young planetary nebula, reveals that the object has an hourglass shape with an intricate pattern of etchings in its walls. A planetary nebula is the glowing relic of a dying, Sun-like star.

  18. The Stigma of Dying: Attitudes Toward the Terminally Ill

    ERIC Educational Resources Information Center

    Epley, Rita J.; McCaghy, Charles H.

    1978-01-01

    Using a range of semantic differential adjectives, 233 college students indicated attitudes toward young and old people who were healthy, ill, or terminally ill. Attitudes toward each state of health category separate into three factors: attitudes toward healthy, ill, and dying persons. (Author)

  19. Interaktive Visualisierung von Abständen und Ausdehnungen anatomischer Strukturen für die Interventionsplanung

    NASA Astrophysics Data System (ADS)

    Rössling, Ivo; Cyrus, Christian; Dornheim, Lars; Hahn, Peter; Preim, Bernhard; Boehm, Andreas

    Im Rahmen der Interventionsplanung muss der Chirurg therapierelevante Entscheidungen auf Basis räumlicher Relationen anatomischer Strukturen treffen. Interaktive 3D-Visualisierungen unterstützen diesen Prozess qualitativ. Quantitative Fragestellungen (Tumorausdehnung, Infiltrationstiefe, etc.) erfordern die Integration einer Bemaßung, deren Nutzen wesentlich von einer geeigneten Darstellung abhängt. In dieser Arbeit haben wir allgemeine Kriterien für die Eignung von Visualisierungen von Bemaßungen in interaktiven 3D-Szenen erarbeitet. Daran orientierend haben wir verschiedene Varianten der Darstellung von Abständen und Ausdehnungen anatomischer Strukturen betrachtet und ihr Erscheinungsbild hierzu zweckmäßig parametrisiert. Die Ausprägungen dieser Darstellungsparameter wurden in einer Studie auf ihre visuellen Wirkung hin an Chirurgen evaluiert. Es zeigte sich, dass die befragten Mediziner höchsten Wert auf Kohärenz und klare Zuordnung der Bemaßung setzten und überraschenderweise dafür sogar Abstriche in der direkten Lesbarkeit in Kauf nahmen.

  20. All Things Death and Dying: Health Professional Students Participating in the Death Café Model.

    PubMed

    Nelson, Katie E; Wright, Rebecca; Abshire, Martha; Davidson, Patricia M

    2018-06-01

    Death and dying remains a taboo topic in many social settings, and is underrepresented in health profession training. This report describes the use of the Death Café model as a forum for engaging students in discussion of death and dying with their peers and other health professionals. A Death Café is an opportunity for individuals to gather in an informal environment to exchange thoughts about issues associated with death, dying, loss, and illness. This report outlines the preparation, implementation, and evaluation of a Death Café event hosted at a nursing school as part of an academic health center. Twenty-four participants from five disciplines participated in discussions, reported positive experiences, and desired to learn more about issues surrounding death and dying. Findings from this event suggest that this approach may be useful for institutions seeking to provide additional learning opportunities for students and/or healthcare professionals on palliative and end-of-life care in a supportive and enabling context.

  1. Roll-to-roll Slot-die Printed Polymer Solar Cell by Self-Assembly.

    PubMed

    Yang, Junyu; Lin, Yuanbao; Zheng, Wenhao; Liu, Alei; Cai, Wanzhu; Yu, Xiaomin; Zhang, Fengling; Liang, Quanbin; Wu, Hongbin; Qin, Donghuan; Hou, Lintao

    2018-06-12

    Extremely simplified one-step roll-to-roll slot-die printed flexible ITO-free polymer solar cells (PSCs) are demonstrated based on ternary blends of electron-donor polymer thieno [3,4-b]thiophene/benzodithiophene (PTB7), electron-acceptor fullerene [6,6]-phenyl-C71-butyric acid methyl ester (PC71BM) and electron extracting polymer poly [(9,9-bis(3'-(N,N-dimethylamino)propyl)-2,7-fluorene)-alt-2,7-(9,9-dioctylfluorene)] (PFN) at room temperature (RT) in ambient air. The flexible ITO-free PSC exhibits a comparable power conversion efficiency (PCE) with the device employing complicated two-step slot-die printing (5.29% vs 5.41%), which indicates that PFN molecules can migrate from the ternary nanocomposite towards Ag cathode via vertical self-assembly during the one-step slot-die printing process in air. To confirm the migration of PFN, the morphology and elemental analysis as well as charge transport of different active layers are investigated with in-situ transient film drying process, transmission electron microscopy, atomic force microscopy, contact angle and surface energy, X-ray photoelectron spectroscopy, scanning electron microscope, impedance spectroscopy, transient photovoltage and transient photocurrent as well as laser beam induced current. Moreover, the good air and mechanical stability of the flexible device with a decent PCE achieved in 1 cm2 PSCs at RT in air suggests the feasibility of energy-saving and time-saving one-step slot-die printing to large-scale roll-to-roll manufacture in the future.

  2. Limitation of Shrinkage Porosity in Aluminum Rotor Die Casting

    NASA Astrophysics Data System (ADS)

    Kim, Young-Chan; Choi, Se-Weon; Kim, Cheol-Woo; Cho, Jae-Ik; Lee, Sung-Ho; Kang, Chang-Seog

    Aluminum rotor prone to have many casting defects especially large amount of air and shrinkage porosity, which caused eccentricity, loss and noise during motor operation. Many attempts have been made to develop methods of shrinkage porosity control, but still there are some problems to solve. In this research, the process of vacuum squeeze die casting is proposed for limitation of defects. The 6 pin point gated dies which were in capable of local squeeze at the end ring were used. Influences of filling patterns on HPDC were evaluated and the important process control parameters were high injection speed, squeeze length, venting and process conditions. By using local squeeze and vacuum during filling and solidification, air and shrinkage porosity were significantly reduced and the feeding efficiency at the upper end ring was improved 10%. As a result of controlling the defects, the dynamometer test showed improved motor efficiency by more than 4%.

  3. Nurses' perceptions of spiritual care and attitudes toward the principles of dying with dignity: A sample from Turkey.

    PubMed

    Gurdogan, Eylem Pasli; Kurt, Duygu; Aksoy, Berna; Kınıcı, Ezgi; Şen, Ayla

    2017-03-01

    Spiritual care is vital for holistic care and dying with dignity. The aim of this study was to determine nurses' perceptions of spiritual care and their attitudes toward dying with dignity. This study was conducted with 289 nurses working at a public hospital. Results showed three things. First, spiritual care perceptions and attitudes toward dying with dignity were more positive in female participants than in male participants. Second, there was a correlation between participants' education levels and their perceptions of spiritual care. Third, there was also a correlation between participants' attitudes toward dying with dignity and their perceptions of spiritual care.

  4. Bacteria Interactions with Dying Diatoms

    NASA Astrophysics Data System (ADS)

    Smriga, S.; Juarez, G.; Fernandez, V.; Stocker, R.

    2016-02-01

    Dying phytoplankton are surrounded by microscale gradients of dissolved organic matter (DOM) that can attract bacteria. These 'phycospheres' may impact the trophic transfer of DOM in the marine microbial food web and enable the growth of bacterial populations, yet these effects remain poorly quantified particularly in relation to the physiological state of the phytoplankton. We dissected phycosphere interactions at unprecedented spatial and temporal resolution using the model diatom Thalassiosira weissflogii and the bacterium Marinobacter adhaerans. Diatom stress was stimulated by addition of polyunsaturated aldehyde (PUA) and both diatom and bacterial responses were captured via time-lapse fluorescence microscopy. We found that stressed diatoms underwent lysis 10-15 h after PUA treatment. Coordinated with the timing of this transition into phytodetritus, wild-type Marinobacter accumulated via chemotaxis near the diatoms immediately following lysis. In contrast, at lysis there was no accumulation of either a non-chemotactic or a non-motile mutant of Marinobacter, pointing to behavioral rather than demographic responses as drivers for the accumulation. Despite the lack of response, non-chemotactic as well as non-swimming bacterial cells that by chance attached to or were located near (<30 µm) stressed diatoms experienced more growth than cells further afield. Growth within the phycosphere was even greater after diatom lysis. Through quantification at the microscale, these results reveal that chemotaxis may precede rapid bacterial attachment to stressed and dying diatoms and may be integral to the microbial colonization of new phytodetritus during phytoplankton blooms and bloom collapses in coastal ecosystems. Even while chemotactic cells retain a growth advantage given their ability to sense and respond to lysis events, phycosphere DOM provides growth benefits to both motile and non-motile taxa that become attached to or happen to be co-located with new

  5. Continental-scale consequences of tree die-offs in North America: identifying where forest loss matters most

    NASA Astrophysics Data System (ADS)

    Swann, Abigail L. S.; Laguë, Marysa M.; Garcia, Elizabeth S.; Field, Jason P.; Breshears, David D.; Moore, David J. P.; Saleska, Scott R.; Stark, Scott C.; Villegas, Juan Camilo; Law, Darin J.; Minor, David M.

    2018-05-01

    Regional-scale tree die-off events driven by drought and warming and associated pests and pathogens have occurred recently on all forested continents and are projected to increase in frequency and extent with future warming. Within areas where tree mortality has occurred, ecological, hydrological and meteorological consequences are increasingly being documented. However, the potential for tree die-off to impact vegetation processes and related carbon dynamics in areas remote to where die-off occurs has rarely been systematically evaluated, particularly for multiple distinct regions within a given continent. Such remote impacts can occur when climate effects of local vegetation change are propagated by atmospheric circulation—the phenomena of ‘ecoclimate teleconnections’. We simulated tree die-off events in the 13 most densely forested US regions (selected from the 20 US National Ecological Observatory Network [NEON] domains) and found that tree die-off even for smaller regions has potential to affect climate and hence Gross Primary Productivity (GPP) in disparate regions (NEON domains), either positively or negatively. Some regions exhibited strong teleconnections to several others, and some regions were relatively sensitive to tree loss regardless of what other region the tree loss occurred in. For the US as a whole, loss of trees in the Pacific Southwest—an area undergoing rapid tree die-off—had the largest negative impact on remote US GPP whereas loss of trees in the Mid-Atlantic had the largest positive impact. This research lays a foundation for hypotheses that identify how the effects of tree die-off (or other types of tree loss such as deforestation) can ricochet across regions by revealing hot-spots of forcing and response. Such modes of connectivity have direct applicability for improving models of climate change impacts and for developing more informed and coordinated carbon accounting across regions.

  6. 25 CFR 304.2 - Marking and ownership of dies.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Marking and ownership of dies. 304.2 Section 304.2 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER, USE OF... owned by the Indian Arts and Crafts Board. ...

  7. 8. INTERIOR BEADED WALL BOARDING SHOWING TRIAL MARKS FROM DIES ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. INTERIOR BEADED WALL BOARDING SHOWING TRIAL MARKS FROM DIES MADE IN CARPENTER'S SHOP Ph: Jack E, Boucher - March 1961 - Joseph Carpenter Silversmith Shop, 71 East Town Street, Norwichtown, New London County, CT

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

    PubMed

    Bailey, Cara; Murphy, Roger; Porock, Davina

    2011-12-01

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

  9. Deburring die-castings by wet vibratory plant

    NASA Astrophysics Data System (ADS)

    Loeschbart, H. M.

    1980-02-01

    A wet vibratory procedure for the removal of burrs from die castings is described. In this process synthetic abrasive chips and detergent solutions are agitated with the work in such a way as to produce a spiral circulatory movement. Details of various forms of vibrator basin and shapes of abrasive are illustrated. The automation of deburring is illustrated through the application of vibrators of spiral design in combination with transport and drying devices.

  10. Deburring die-castings by wet vibratory plant

    NASA Technical Reports Server (NTRS)

    Loeschbart, H. M.

    1980-01-01

    A wet vibratory procedure for the removal of burrs from die castings is described. In this process synthetic abrasive chips and detergent solutions are agitated with the work in such a way as to produce a spiral circulatory movement. Details of various forms of vibrator basin and shapes of abrasive are illustrated. The automation of deburring is illustrated through the application of vibrators of spiral design in combination with transport and drying devices.

  11. 33. HISTORIC PLAQUE MARKING WHERE JOHNSTON DIED, ADJACENT TO PATHWAY ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    33. HISTORIC PLAQUE MARKING WHERE JOHNSTON DIED, ADJACENT TO PATHWAY WITH CONCRETE CULVERT LEADING NORTH OUT OF RAVINE TOWARD JOHNSTON MEMORIAL SITE. VIEW NW. - Shiloh National Military Park Tour Roads, Shiloh, Hardin County, TN

  12. Der Einfluss von Alitretinoin auf die Lebensqualität bei Patienten mit schwerem chronischen Handekzem: FUGETTA - Beobachtungsstudie unter Praxisbedingungen.

    PubMed

    Augustin, Matthias; Thaçi, Diamant; Kamps, Anja

    2016-12-01

    Alitretinoin ist die einzige zugelassene Behandlung für schweres chronisches Handekzem (CHE), das refraktär gegenüber potenten topischen Corticosteroiden ist. Bei dieser Studie (FUGETTA) wurde die Wirksamkeit von leitliniengerecht angewendetem oralem Alitretinoin sowie dessen Einfluss auf die Lebensqualität (LQ) bei Patienten mit schwerem refraktärem CHE beurteilt. Multizentrische, offene, nichtinterventionelle Beobachtungsstudie, durchgeführt in Deutschland. Die Patienten wurden nach Ermessen ihres behandelnden Arztes mit Alitretinoin 10 mg oder 30 mg einmal täglich über maximal 24 Wochen behandelt. Die Wirksamkeit wurde anhand des Physician Global Assessment (PGA) und des Dermatology Life Quality Index (DLQI) bewertet. Zudem wurden unerwünschte Ereignisse (UE) erfasst. Die Studienpopulation bestand aus 658 Patienten (30 mg: n = 581; 10 mg: n = 77). Bei Beobachtungsbeginn litten die meisten Patienten (83 %) gemäß PGA an einem schweren CHE. Bei Beobachtungsende war das Handekzem bei 48 % der Patienten gemäß PGA vollständig oder fast vollständig abgeheilt (30 mg: 49 %; 10 mg: 43 %). Die mittlere Verbesserung des DLQI-Scores in Woche 24 betrug 58 % (30 mg: mittlere [SD] Veränderung gegenüber dem Ausgangswert -10,4 [8,04]) und 70 % (10 mg: mittlere [SD] Veränderung gegenüber dem Ausgangswert -10,8 [7,29]). Die Gesamtinzidenz von NW war niedrig und in den beiden Gruppen ähnlich. Alitretinoin führte zu einer schnellen, deutlichen Verbesserung der LQ bei Patienten mit schwerem CHE. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  13. Changing laws on medical assistance in dying: Implications for critical care nurses.

    PubMed

    Edwards, Marie

    2016-10-01

    In February 2015, the Supreme Court of Canada released its decision in the Carter v. Canada (Attorney General) case, declaring section 241(b) and section 14 of the Criminal Code invalid, and granting a one-year suspension on that declaration to enable the Parliament of Canada to respond. In June 2016, Bill C-14: An Act to Amend the Criminal Code and Make Related Amendments to Other Acts (Medical Assistance in Dying) was passed after much debate in the House of Commons and Senate of Canada. Brief summaries of the Carter v. Canada case and the new federal law are provided and questions regarding medical assistance in dying are explored. The implications of the case and the new law for critical care nurses are also examined, including the need for nurses to attend to legislative changes, the need for education about the roles of nurses in medical assistance in dying, particularly what can be learned from other jurisdictions, and the importance of understanding the concept of conscientious objection.

  14. Death and Dying Education in a Medical School Curriculum.

    ERIC Educational Resources Information Center

    Schachter, Steven C.

    1979-01-01

    A student-initiated course on death and dying, offered at the Case Western Reserve University School of Medicine, features a small group format, multidisciplinary representation, and student leadership. Course objectives, course content, teaching methods, course design, and student and faculty assessment of the course are discussed. (JMD)

  15. [Recognizing and defining dying. Analysis of end-of-life coverage in German nursing textbooks].

    PubMed

    Pleschberger, Sabine; Hornek, Alexandra

    2011-08-01

    Text books play an important role in basic education in nursing. This study aimed at capturing the extent and content of end-of-life issues in nursing text books in German language. For that reason, a quantitative and a qualitative analysis of relevant content in a comprehensive sample of nursing text books available (n = 65) were conducted. Whereas 29.2 % of the books do not cover the issue at all, 44.5 % dedicate a separate chapter to the issue of dying, which accounts for 1.34 % of all pages on average. Of all specialties, both surgery and internal medicine feature the lowest, and paediatrics and oncology the highest share of coverage. 41.53 % of all text books studied contain a definition of the term dying which is based on a great variety of approaches. 23 books list criteria that define the recognition of dying, 21 of which draw attention to symptoms of impending death. 84 % of the books refer to the work of Elisabeth Kübler-Ross. Overall, the amount of coverage of the issue of dying in nursing text books can be considered marginal by international comparison. What is problematic is the conceptual reduction to physiological signs of impending death and the lack of references to existing theoretical work. Integration of knowledge from the area of palliative care in all specialties is strongly needed. Additionally, there is a need for a stronger conceptual debate in order to avoid problems in communication about death and dying in nursing education and practice.

  16. Pathogen response-like recruitment and activation of neutrophils by sterile immunogenic dying cells drives neutrophil-mediated residual cell killing

    PubMed Central

    Garg, Abhishek D; Vandenberk, Lien; Fang, Shentong; Fasche, Tekele; Van Eygen, Sofie; Maes, Jan; Van Woensel, Matthias; Koks, Carolien; Vanthillo, Niels; Graf, Norbert; de Witte, Peter; Van Gool, Stefaan; Salven, Petri; Agostinis, Patrizia

    2017-01-01

    Innate immune sensing of dying cells is modulated by several signals. Inflammatory chemokines-guided early recruitment, and pathogen-associated molecular patterns-triggered activation, of major anti-pathogenic innate immune cells like neutrophils distinguishes pathogen-infected stressed/dying cells from sterile dying cells. However, whether certain sterile dying cells stimulate innate immunity by partially mimicking pathogen response-like recruitment/activation of neutrophils remains poorly understood. We reveal that sterile immunogenic dying cancer cells trigger (a cell autonomous) pathogen response-like chemokine (PARC) signature, hallmarked by co-release of CXCL1, CCL2 and CXCL10 (similar to cells infected with bacteria or viruses). This PARC signature recruits preferentially neutrophils as first innate immune responders in vivo (in a cross-species, evolutionarily conserved manner; in mice and zebrafish). Furthermore, key danger signals emanating from these dying cells, that is, surface calreticulin, ATP and nucleic acids stimulate phagocytosis, purinergic receptors and toll-like receptors (TLR) i.e. TLR7/8/9-MyD88 signaling on neutrophil level, respectively. Engagement of purinergic receptors and TLR7/8/9-MyD88 signaling evokes neutrophil activation, which culminates into H2O2 and NO-driven respiratory burst-mediated killing of viable residual cancer cells. Thus sterile immunogenic dying cells perform 'altered-self mimicry' in certain contexts to exploit neutrophils for phagocytic targeting of dead/dying cancer cells and cytotoxic targeting of residual cancer cells. PMID:28234357

  17. [Heatwaves and population die off in the Voronezh city].

    PubMed

    Mekhant'ev, I I; Pichuzhkina, N M; Masaĭlova, L A

    2013-01-01

    Climatic factor is most important condition for the formation of public health. Attention to it has increased recently against the background of global and regional climate change. The aim of the study was to investigate the effect of air temperature on population die off in the Voronezh city in the period of fire-related emergencies. Assessment of cause-and-effect relationships between the air temperature and daily death cases s was performed with the help of the method of time series. Correlation analysis showed a statistically significant positive relationship between air temperature and population die off from all causes and from diseases of the circulatory system with a lag of 0, 1, 2, 3 days; respiratory diseases - with a lag of 3 days. With the gain in air temperature by one degree the number of deaths increases by 3%. The results were used in adopt management decisions on minimization risks and potential negative effects on human health.

  18. Thermal Stress Analysis for Ceramics Stalk in the Low Pressure Die Casting Machine

    NASA Astrophysics Data System (ADS)

    Noda, Nao-Aki; Hendra, Nao-Aki; Takase, Yasushi; Li, Wenbin

    Low pressure die casting (LPDC) is defined as a net shape casting technology in which the molten metal is injected at high speeds and pressure into a metallic die. The LPDC process is playing an increasingly important role in the foundry industry as a low-cost and high-efficiency precision forming technique. The LPDC process is that the permanent die and filling systems are placed over the furnace containing the molten alloy. The filling of the cavity is obtained by forcing the molten metal by means of a pressurized gas in order to rise into a ceramic tube, which connects the die to the furnace. The ceramics tube called stalk has high temperature resistance and high corrosion resistance. However, attention should be paid to the thermal stress when the stalk is dipped into the molten aluminum. It is important to develop the design of the stalk to reduce the risk of fracture because of low fracture toughness of ceramics. In this paper, therefore, the finite element method is applied to calculate the thermal stresses when the stalk is dipped into the crucible by varying the dipping speeds and dipping directions. It is found that the thermal stress can be reduced by dipping slowly if the stalk is dipped into the crucible vertically, while the thermal stress can be reduced by dipping fast if it is dipped horizontally.

  19. End-of-life care policy: An integrated care plan for the dying

    PubMed Central

    Myatra, Sheila Nainan; Salins, Naveen; Iyer, Shivakumar; Macaden, Stanley C.; Divatia, Jigeeshu V.; Muckaden, Maryann; Kulkarni, Priyadarshini; Simha, Srinagesh; Mani, Raj Kumar

    2014-01-01

    Purpose: The purpose was to develop an end-of-life care (EOLC) policy for patients who are dying with an advanced life limiting illness and to develop practical procedural guidelines for limiting inappropriate therapeutic medical interventions and improve the quality of care of the dying within an ethical framework and through a professional and family/patient consensus process. Evidence: The Indian Society of Critical Care Medicine (ISCCM) published its first guidelines on EOLC in 2005 [1] which was later revised in 2012.[2] Since these publications, there has been an exponential increase in empirical information and discussion on the subject. The literature reviewed observational studies, surveys, randomized controlled studies, as well as guidelines and recommendations, for education and quality improvement published across the world. The search terms were: EOLC; do not resuscitate directives; withdrawal and withholding; intensive care; terminal care; medical futility; ethical issues; palliative care; EOLC in India; cultural variations. Indian Association of Palliative Care (IAPC) also recently published its consensus position statement on EOLC policy for the dying.[3] Method: An expert committee of members of the ISCCM and IAPC was formed to make a joint EOLC policy for the dying patients. Proposals from the chair were discussed, debated, and recommendations were formulated through a consensus process. The members extensively reviewed national and international established ethical principles and current procedural practices. This joint EOLC policy has incorporated the sociocultural, ethical, and legal perspectives, while taking into account the needs and situation unique to India. PMID:25249748

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

    PubMed

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

    2009-11-01

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

  1. Stress distribution and pressure-bearing capacity of a high-pressure split-cylinder die with prism cavity

    NASA Astrophysics Data System (ADS)

    Zhao, Liang; Li, Mingzhe; Wang, Liyan; Qu, Erhu; Yi, Zhuo

    2018-03-01

    A novel high-pressure belt-type die with a split-type cylinder is investigated with respect to extending its lifetime and improving its pressure bearing capacity. Specifically, a tungsten carbide cylinder is split into several parts along the radial direction with a prism-type cavity. In this paper, the cylinders with different split numbers are chosen to study the stress distribution and compare them with the traditional belt-type die. The simulation results indicate that the split cylinder has much smaller stress than those in the belt-type cylinder, and the statistical analysis reveals that the split-pressure cylinder is able to bear higher pressure. Experimental tests also show that the high-pressure die with a split cylinder and prism cavity has a stronger pressure-bearing capacity than a belt-type die. The split cylinder has advantages of easy manufacturing, high pressure bearing capacity, and replaceable performance.

  2. Examining the Effect of the Die Angle on Tool Load and Wear in the Extrusion Process

    NASA Astrophysics Data System (ADS)

    Nowotyńska, Irena; Kut, Stanisław

    2014-04-01

    The tool durability is a crucial factor in each manufacturing process, and this also includes the extrusion process. Striving to achieve the higher product quality should be accompanied by a long-term tool life and production cost reduction. This article presents the comparative research of load and wear of die at various angles of working cone during the concurrent extrusion. The numerical calculations of a tool load during the concurrent extrusion were performed using the MSC MARC software using the finite element method (FEM). Archard model was used to determine and compare die wear. This model was implemented in the software using the FEM. The examined tool deformations and stress distribution were determined based on the performed analyses. The die wear depth at various working cone angles was determined. Properly shaped die has an effect on the extruded material properties, but also controls loads, elastic deformation, and the tool life.

  3. Tribological and Wear Performance of Nanocomposite PVD Hard Coatings Deposited on Aluminum Die Casting Tool

    PubMed Central

    Fox-Rabinovich, German; Locks Junior, Edinei; Stolf, Pietro; Matos Martins, Marcelo

    2018-01-01

    In the aluminum die casting process, erosion, corrosion, soldering, and die sticking have a significant influence on tool life and product quality. A number of coatings such as TiN, CrN, and (Cr,Al)N deposited by physical vapor deposition (PVD) have been employed to act as protective coatings due to their high hardness and chemical stability. In this study, the wear performance of two nanocomposite AlTiN and AlCrN coatings with different structures were evaluated. These coatings were deposited on aluminum die casting mold tool substrates (AISI H13 hot work steel) by PVD using pulsed cathodic arc evaporation, equipped with three lateral arc-rotating cathodes (LARC) and one central rotating cathode (CERC). The research was performed in two stages: in the first stage, the outlined coatings were characterized regarding their chemical composition, morphology, and structure using glow discharge optical emission spectroscopy (GDOES), scanning electron microscopy (SEM), and X-ray diffraction (XRD), respectively. Surface morphology and mechanical properties were evaluated by atomic force microscopy (AFM) and nanoindentation. The coating adhesion was studied using Mersedes test and scratch testing. During the second stage, industrial tests were carried out for coated die casting molds. In parallel, tribological tests were also performed in order to determine if a correlation between laboratory and industrial tests can be drawn. All of the results were compared with a benchmark monolayer AlCrN coating. The data obtained show that the best performance was achieved for the AlCrN/Si3N4 nanocomposite coating that displays an optimum combination of hardness, adhesion, soldering behavior, oxidation resistance, and stress state. These characteristics are essential for improving the die mold service life. Therefore, this coating emerges as a novelty to be used to protect aluminum die casting molds. PMID:29495620

  4. Tribological and Wear Performance of Nanocomposite PVD Hard Coatings Deposited on Aluminum Die Casting Tool.

    PubMed

    Paiva, Jose Mario; Fox-Rabinovich, German; Locks Junior, Edinei; Stolf, Pietro; Seid Ahmed, Yassmin; Matos Martins, Marcelo; Bork, Carlos; Veldhuis, Stephen

    2018-02-28

    In the aluminum die casting process, erosion, corrosion, soldering, and die sticking have a significant influence on tool life and product quality. A number of coatings such as TiN, CrN, and (Cr,Al)N deposited by physical vapor deposition (PVD) have been employed to act as protective coatings due to their high hardness and chemical stability. In this study, the wear performance of two nanocomposite AlTiN and AlCrN coatings with different structures were evaluated. These coatings were deposited on aluminum die casting mold tool substrates (AISI H13 hot work steel) by PVD using pulsed cathodic arc evaporation, equipped with three lateral arc-rotating cathodes (LARC) and one central rotating cathode (CERC). The research was performed in two stages: in the first stage, the outlined coatings were characterized regarding their chemical composition, morphology, and structure using glow discharge optical emission spectroscopy (GDOES), scanning electron microscopy (SEM), and X-ray diffraction (XRD), respectively. Surface morphology and mechanical properties were evaluated by atomic force microscopy (AFM) and nanoindentation. The coating adhesion was studied using Mersedes test and scratch testing. During the second stage, industrial tests were carried out for coated die casting molds. In parallel, tribological tests were also performed in order to determine if a correlation between laboratory and industrial tests can be drawn. All of the results were compared with a benchmark monolayer AlCrN coating. The data obtained show that the best performance was achieved for the AlCrN/Si₃N₄ nanocomposite coating that displays an optimum combination of hardness, adhesion, soldering behavior, oxidation resistance, and stress state. These characteristics are essential for improving the die mold service life. Therefore, this coating emerges as a novelty to be used to protect aluminum die casting molds.

  5. Construction of a test bench for closed die forging

    NASA Astrophysics Data System (ADS)

    Batit, G.; Kaczmarek, B.; Ravassard, P.

    1984-03-01

    A swan neck press was equipped with hydraulic jacks to enable it to press and forge complex shapes in closed dies in one operation without wasting metal. Maximum closing stress is 250 kN, maximum pressing stress is 250 kN, maximum forging stress is 70 kN.

  6. 5 Ways to Cope When a Loved One Dies

    MedlinePlus

    ... in rituals. Memorial services, funerals, and other traditions help people get through the first few days and honor the person who died. Just being in the presence of other people who knew your loved one can be comforting. Let your emotions be expressed and released. Don't stop yourself ...

  7. Breaking bad news about transitions to dying: a qualitative exploration of the role of the District Nurse.

    PubMed

    Griffiths, Jane; Ewing, Gail; Wilson, Charlotte; Connolly, Michael; Grande, Gunn

    2015-02-01

    UK District Nurses have an important role in enabling a good death. Patients and families need to know the patient is approaching the dying phase, yet evidence suggests breaking bad news about the patient's transition to dying rarely happens. District Nurses spend a lot of time with patients and families during the dying phase and are ideally placed to recognise and discuss the transition to dying. To explore the role of District Nurses in breaking bad news of transition to dying. Qualitative focus groups. Primary care (District Nurse service); Four National Health Service Trusts, North West England. A total of 40 District Nurses across the Trusts, all Registered General Nurse qualified. Median number of years as a District Nurse was 12.5. All had palliative cancer patients on their caseloads. District Nurses' role in breaking bad news of transition to dying was challenging, but the conversation was described as essential preparation for a good death. Four main challenges with the conversations were patients' responses to the prognosis (unawareness, denial and anger), timing the conversation, complexities of the home environment and limited preparation in this aspect of their work. District Nurses are with patients during their last weeks of life. While other colleagues can avoid breaking bad news of transition to dying, District Nurses have no choice if they are to provide optimal end of life care. While ideally placed to carry out this work, it is complex and they are unprepared for it. They urgently need carefully tailored training in this aspect of their work, to enable them to provide optimal end of life care. © The Author(s) 2014.

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

    PubMed

    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.

  9. Fear, Pain, Denial, and Spiritual Experiences in Dying Processes

    PubMed Central

    Reichmuth, O.; Bueche, D.; Traichel, B.; Mao, M. Schuett; Cerny, T.; Strasser, F.

    2017-01-01

    Purpose: Approaching death seems to be associated with physiological/spiritual changes. Trajectories including the physical–psychological–social–spiritual dimension have indicated a terminal drop. Existential suffering or deathbed visions describe complex phenomena. However, interrelationships between different constituent factors (e.g., fear and pain, spiritual experiences and altered consciousness) are largely unknown. We lack deeper understanding of patients’ inner processes to which care should respond. In this study, we hypothesized that fear/pain/denial would happen simultaneously and be associated with a transformation of perception from ego-based (pre-transition) to ego-distant perception/consciousness (post-transition) and that spiritual (transcendental) experiences would primarily occur in periods of calmness and post-transition. Parameters for observing transformation of perception (pre-transition, transition itself, and post-transition) were patients’ altered awareness of time/space/body and patients’ altered social connectedness. Method: Two interdisciplinary teams observed 80 dying patients with cancer in palliative units at 2 Swiss cantonal hospitals. We applied participant observation based on semistructured observation protocols, supplemented by the list of analgesic and psychotropic medication. Descriptive statistical analysis and Interpretative Phenomenological Analysis (IPA) were combined. International interdisciplinary experts supported the analysis. Results: Most patients showed at least fear and pain once. Many seemed to have spiritual experiences and to undergo a transformation of perception only partly depending on medication. Line graphs representatively illustrate associations between fear/pain/denial/spiritual experiences and a transformation of perception. No trajectory displayed uninterrupted distress. Many patients seemed to die in peace. Previous near-death or spiritual/mystical experiences may facilitate the dying

  10. Thinking about dying and trying and intending to die: results on suicidal behavior from a large Web-based sample.

    PubMed

    de Araújo, Rafael M F; Mazzochi, Leonardo; Lara, Diogo R; Ottoni, Gustavo L

    2015-03-01

    Suicide is an important worldwide public health problem. The aim of this study was to characterize risk factors of suicidal behavior using a large Web-based sample. The data were collected by the Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP) from November 2010 to July 2011. Suicidal behavior was assessed by an instrument based on the Suicidal Behaviors Questionnaire. The final sample consisted of 48,569 volunteers (25.9% men) with a mean ± SD age of 30.7 ± 10.1 years. More than 60% of the sample reported having had at least a passing thought of killing themselves, and 6.8% of subjects had previously attempted suicide (64% unplanned). The demographic features with the highest risk of attempting suicide were female gender (OR = 1.82, 95% CI = 1.65 to 2.00); elementary school as highest education level completed (OR = 2.84, 95% CI = 2.48 to 3.25); being unable to work (OR = 5.32, 95% CI = 4.15 to 6.81); having no religion (OR = 2.08, 95% CI = 1.90 to 2.29); and, only for female participants, being married (OR = 1.19, 95% CI = 1.08 to 1.32) or divorced (OR = 1.66, 95% CI = 1.41 to 1.96). A family history of a suicide attempt and of a completed suicide showed the same increment in the risk of suicidal behavior. The higher the number of suicide attempts, the higher was the real intention to die (P < .05). Those who really wanted to die reported more emptiness/loneliness (OR = 1.58, 95% CI = 1.35 to 1.85), disconnection (OR = 1.54, 95% CI = 1.30 to 1.81), and hopelessness (OR = 1.74, 95% CI = 1.49 to 2.03), but their methods were not different from the methods of those who did not mean to die. This large Web survey confirmed results from previous studies on suicidal behavior and pointed out the relevance of the number of previous suicide attempts and of a positive family history, even for a noncompleted suicide, as important risk factors. © Copyright 2015 Physicians Postgraduate Press, Inc.

  11. 26 CFR 20.2201-1 - Members of the Armed Forces dying during an induction period.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Members of the Armed Forces dying during an... Miscellaneous § 20.2201-1 Members of the Armed Forces dying during an induction period. (a) The additional...) (see paragraph (b) of this section) and while in active service as a member of the Armed Forces of the...

  12. Setup of a Parameterized FE Model for the Die Roll Prediction in Fine Blanking using Artificial Neural Networks

    NASA Astrophysics Data System (ADS)

    Stanke, J.; Trauth, D.; Feuerhack, A.; Klocke, F.

    2017-09-01

    Die roll is a morphological feature of fine blanked sheared edges. The die roll reduces the functional part of the sheared edge. To compensate for the die roll thicker sheet metal strips and secondary machining must be used. However, in order to avoid this, the influence of various fine blanking process parameters on the die roll has been experimentally and numerically studied, but there is still a lack of knowledge on the effects of some factors and especially factor interactions on the die roll. Recent changes in the field of artificial intelligence motivate the hybrid use of the finite element method and artificial neural networks to account for these non-considered parameters. Therefore, a set of simulations using a validated finite element model of fine blanking is firstly used to train an artificial neural network. Then the artificial neural network is trained with thousands of experimental trials. Thus, the objective of this contribution is to develop an artificial neural network that reliably predicts the die roll. Therefore, in this contribution, the setup of a fully parameterized 2D FE model is presented that will be used for batch training of an artificial neural network. The FE model enables an automatic variation of the edge radii of blank punch and die plate, the counter and blank holder force, the sheet metal thickness and part diameter, V-ring height and position, cutting velocity as well as material parameters covered by the Hensel-Spittel model for 16MnCr5 (1.7131, AISI/SAE 5115). The FE model is validated using experimental trails. The results of this contribution is a FE model suitable to perform 9.623 simulations and to pass the simulated die roll width and height automatically to an artificial neural network.

  13. Dying, mourning, and spirituality: a psychological perspective.

    PubMed

    Marrone, R

    1999-09-01

    Based in an unfortunate tradition that stretches back in time to Watson's behaviorism and Freud's psychoanalysis, psychology has tended to reject and to pathologize matters of the spirit. In the past 30 years, however, with the advent of what has been termed the cognitive revolution, psychology has greatly expanded the scope of its subject matter. Psychologists and thanatologists have begun to unravel the cognitive underpinnings of our assumptive world and the transformation of those underpinnings in times of crisis and stress. This article examines the cognitive basis of the spiritual experience and the use of cognitive assimilation, accommodation strategies during the process of mourning the death of a loved one, as well as during the process of living our own dying. Of special importance to mental health professionals and clergy, new research on dying, mourning, and spirituality suggests that the specific ways in which people rediscover meaning--such as belief in traditional religious doctrine, the afterlife, reincarnation, philanthropy, or a spiritual order to the universe--may be less important than the process itself. In other words, in the midst of dealing with profound loss in our lives, the ability to reascribe meaning to a changed world through spiritual transformation, religious conversion, or existential change may be more significant than the specific content by which that need is filled.

  14. Effect of particle size on in-die and out-of-die compaction behavior of ranitidine hydrochloride polymorphs.

    PubMed

    Khomane, Kailas S; Bansal, Arvind K

    2013-09-01

    The present study investigates the effect of particle size on compaction behavior of forms I and II of ranitidine hydrochloride. Compaction studies were performed using three particle size ranges [450-600 (A), 300-400 (B), and 150-180 (C) μm] of both the forms, using a fully instrumented rotary tableting machine. Compaction data were analyzed for out-of-die compressibility, tabletability, and compactibility profiles and in-die Heckel and Kawakita analysis. Tabletability of the studied size fractions followed the order; IB > IA > > IIC > IIB > IIA at all the compaction pressures. In both the polymorphs, decrease in particle size improved the tabletability. Form I showed greater tabletability over form II at a given compaction pressure and sized fraction. Compressibility plot and Heckel and Kawakita analysis revealed greater compressibility and deformation behavior of form II over form I at a given compaction pressure and sized fraction. Decrease in particle size increased the compressibility and plastic deformation of both the forms. For a given polymorph, improved tabletability of smaller sized particles was attributed to their increased compressibility. However, IA and IB, despite poor compressibility and deformation, showed increased tabletability over IIA, IIB, and IIC by virtue of their greater compactibility. Microtensile testing also revealed higher nominal fracture strength of form I particles over form II, thus, supporting greater compactibility of form I. Taken as a whole, though particle size exhibited a trend on tabletability of individual forms, better compactibility of form I over form II has an overwhelming impact on tabletability.

  15. Learning from Clients: Counseling the Frail and Dying Elderly.

    ERIC Educational Resources Information Center

    Kemp, James T.

    1984-01-01

    Contends that experience with a frail or dying client is a learning opportunity for the counselor. Presents several examples illustrating the reactions of the elderly to approaching death and suggests that successful counselors accept their own mortality and acknowledge the decision of the failing elderly that death is near. (JAC)

  16. Dreams of the Dying Patient: An Exploration of Content.

    ERIC Educational Resources Information Center

    Prince, Pamela N.; Hoffmann, Robert F.

    1991-01-01

    Examined 25 dream reports of individuals in Palliative Care Unit. Content analysis of dream reports supports hypothesis that continuity exists between dreaming and waking experience. Results did not indicate that themes of death and aggression, negative emotion, or infant and child characters were more prevalent among the dying. (Author/NB)

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

    PubMed

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

    2016-06-01

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

  18. Wirkungen biogener Amine auf die Erregungs-Sekretions-Kopplung in der Speicheldrüse von Periplaneta americana (L.)

    NASA Astrophysics Data System (ADS)

    Rietdorf, Katja

    2003-07-01

    In der vorliegenden Arbeit habe ich wichtige Teilmechanismen der Erregungs-Sekretionskopplung in der Speicheldrüse der Schabe Periplaneta americana (L.) untersucht. Die Speicheldrüse ist von dopaminergen und serotonergen Fasern innerviert (Baumann et al., 2002). Beide Transmitter stimulieren eine unterschiedliche Reaktion der Drüse: Dopamin (DA) stimuliert die P-Zellen der Acini und die Ausführgangzellen, während Serotonin (5-HT) die P- und C-Zellen der Acini stimuliert, nicht jedoch die Ausführgangzellen. Der Endspeichel ist nach einer DA-Stimulierung proteinfrei. Dagegen enthält er nach einer 5-HT-Stimulierung Proteine, die von den C-Zellen sezerniert werden (Just & Walz, 1996). Im ersten Teil meiner Arbeit habe ich mittels Kapillarelektrophoretischer Analyse (CE-Analyse) die Elektrolytkonzentrationen im Endspeichel untersucht sowie die Raten der Flüssigkeitssekretion gemessen. Damit wollte ich klären, welche Transporter an der Sekretion des Primärspeichels und an dessen Modifikation beteiligt sind. Ausserdem wollte ich die Rolle der transportaktiven Epithelzellen der Ausführgänge für die Modifikation des Primärspeichels untersuchen. Dafür habe ich einen Vergleich der Elektrolytkonzentrationen im DA- und 5-HT-stimulierten Endspeichel durchgeführt. Der Elektrolytgehalt des DA- und 5-HT-stimulierten Endspeichels unterscheidet sich nicht signifikant voneinander. Er ist nach beiden Stimulierungen hypoosmotisch zum verwendeten Ringer. Die Ausführgangzellen werden durch DA stimuliert und modifizieren den Primärspeichel durch eine netto-Ionenreabsorption. Meine Versuche zeigen jedoch, dass auch die während einer 5-HT-Stimulierung der Drüse unstimulierten Ausführgangzellen den Primärspeichel modifizieren. In einer nachfolgenden Versuchsreihe habe ich den Einfluss von Ouabain, einem Hemmstoff der Na+-K+-ATPase, und Bumetanid, einem Hemmstoff des NKCC, auf die Raten der Flüssigkeitssekretion sowie den Elektrolytgehalt des Endspeichels untersucht. Ich

  19. Development and Testing of a New Instrument for Measuring Concerns about Dying in Health Care Providers

    ERIC Educational Resources Information Center

    Mazor, Kathleen M.; Schwartz, Carolyn E.; Rogers, H. Jane

    2004-01-01

    A new measure of concerns about dying was investigated in this psychometric study. The Concerns About Dying instrument (CAD) was administered to medical students, nursing students, hospice nurses, and life sciences graduate students ( N = 207) on two occasions; on one occasion they also completed three related measures. Analyses included…

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

    PubMed

    Lin, Yanxia; Myall, Michelle; Jarrett, Nikki

    2017-12-01

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

  1. The ebb and flow of the wish to live and the wish to die among suicidal military personnel.

    PubMed

    Bryan, Craig J; Rudd, M David; Peterson, Alan L; Young-McCaughan, Stacey; Wertenberger, Evelyn G

    2016-09-15

    The relative balance between the wish to live and the wish to die (i.e., suicidal ambivalence) is a robust predictor of suicidal behavior and may be a mechanism underlying the effectiveness of treatments that reduce suicidal behaviors. To date, however, few studies have explored possible mechanisms of action in these treatments. Active duty Soldiers (N=152) with a recent suicide attempt and/or active suicide ideation were randomized to receive brief cognitive behavioral therapy (BCBT) or treatment as usual (TAU). The Suicide Attempt Self-Injury Inventory (Linehan et al., 2006a) was used to assess the incidence of suicide attempts during the 2-year follow-up. The wish to live and the wish to die were assessed with items 1 and 2, respectively, of the Beck Scale for Suicide Ideation (Beck and Steer, 1991). Across both treatments, the wish to live was significantly weaker among patients who attempted suicide but the wish to die was stronger only among patients who attempted suicide in TAU. Among nonattempters, the wish to die stabilized the wish to live, but among attempters the wish to live and the wish to die were not associated with each other. In BCBT the wish to live destabilized the wish to die among nonattempters. Self-report methodology, predominantly male sample. The emergence of suicidal behavior is driven primarily by the absence of the wish to live. BCBT is associated with a unique coupling of an ambivalent wish to live and wish to die, which may suggest an underlying mechanism of action. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Returning home to die: Circular labour migration and mortality in South Africa1

    PubMed Central

    CLARK, SAMUEL J.; COLLINSON, MARK A.; KAHN, KATHLEEN; DRULLINGER, KYLE; TOLLMAN, STEPHEN M.

    2010-01-01

    Aim: To examine the hypothesis that circular labour migrants who become seriously ill while living away from home return to their rural homes to convalesce and possibly to die. Methods: Drawing on longitudinal data collected by the Agincourt health and demographic surveillance system in rural northeastern South Africa between 1995 and 2004, discrete time event history analysis is used to estimate the likelihood of dying for residents, short-term returning migrants, and long-term returning migrants controlling for sex, age, and historical period. Results: The annual odds of dying for short-term returning migrants are generally 1.1 to 1.9 times (depending on period, sex, and age) higher than those of residents and long-term returning migrants, and these differences are generally highly statistically significant. Further supporting the hypothesis is the fact that the proportion of HIV/TB deaths among short-term returning migrants increases dramatically as time progresses, and short-term returning migrants account for an increasing proportion of all HIV/TB deaths. Conclusions: This evidence strongly suggests that increasing numbers of circular labour migrants of prime working age are becoming ill in the urban areas where they work and coming home to be cared for and eventually to die in the rural areas where their families live. This shifts the burden of caring for them in their terminal illness to their families and the rural healthcare system with significant consequences for the distribution and allocation of health care resources. PMID:17676501

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

    PubMed

    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.

  4. Exploring the Counselor's Role in "Right to Die" Decisions.

    ERIC Educational Resources Information Center

    Farrugia, David

    1993-01-01

    Explores issues related to "right to die." Makes case for counselors to assist clients and families with concerns related to refusal or withdrawal of medical treatment in cases of terminal illness or in cases where quality of life is severely impaired such as permanent comatose state. Presents historical, ethical, and legal perspectives.…

  5. Evolutions of Advanced Stamping CAE — Technology Adventures and Business Impact on Automotive Dies and Stamping

    NASA Astrophysics Data System (ADS)

    Wang, Chuantao (C. T.)

    2005-08-01

    In the past decade, sheet metal forming and die development has been transformed to a science-based and technology-driven engineering and manufacturing enterprise from a tryout-based craft. Stamping CAE, especially the sheet metal forming simulation, as one of the core components in digital die making and digital stamping, has played a key role in this historical transition. The stamping simulation technology and its industrial applications have greatly impacted automotive sheet metal product design, die developments, die construction and tryout, and production stamping. The stamping CAE community has successfully resolved the traditional formability problems such as splits and wrinkles. The evolution of the stamping CAE technology and business demands opens even greater opportunities and challenges to stamping CAE community in the areas of (1) continuously improving simulation accuracy, drastically reducing simulation time-in-system, and improving operationalability (friendliness), (2) resolving those historically difficult-to-resolve problems such as dimensional quality problems (springback and twist) and surface quality problems (distortion and skid/impact lines), (3) resolving total manufacturability problems in line die operations including blanking, draw/redraw, trim/piercing, and flanging, and (4) overcoming new problems in forming new sheet materials with new forming techniques. In this article, the author first provides an overview of the stamping CAE technology adventures and achievements, and industrial applications in the past decade. Then the author presents a summary of increasing manufacturability needs from the formability to total quality and total manufacturability of sheet metal stampings. Finally, the paper outlines the new needs and trends for continuous improvements and innovations to meet increasing challenges in line die formability and quality requirements in automotive stamping.

  6. Strong resilience of soil respiration components to drought-induced die-off resulting in forest secondary succession.

    PubMed

    Barba, Josep; Curiel Yuste, Jorge; Poyatos, Rafael; Janssens, Ivan A; Lloret, Francisco

    2016-09-01

    How forests cope with drought-induced perturbations and how the dependence of soil respiration on environmental and biological drivers is affected in a warming and drying context are becoming key questions. The aims of this study were to determine whether drought-induced die-off and forest succession were reflected in soil respiration and its components and to determine the influence of climate on the soil respiration components. We used the mesh exclusion method to study seasonal variations in soil respiration (R S) and its components: heterotrophic (R H) and autotrophic (R A) [further split into fine root (R R) and mycorrhizal respiration (R M)] in a mixed Mediterranean forest where Scots pine (Pinus sylvestris L.) is undergoing a drought-induced die-off and is being replaced by holm oak (Quercus ilex L.). Drought-induced pine die-off was not reflected in R S nor in its components, which denotes a high functional resilience of the plant and soil system to pine die-off. However, the succession from Scots pine to holm oak resulted in a reduction of R H and thus in an important decrease of total respiration (R S was 36 % lower in holm oaks than in non-defoliated pines). Furthermore, R S and all its components were strongly regulated by soil water content-and-temperature interaction. Since Scots pine die-off and Quercus species colonization seems to be widely occurring at the driest limit of the Scots pine distribution, the functional resilience of the soil system over die-off and the decrease of R S from Scots pine to holm oak could have direct consequences for the C balance of these ecosystems.

  7. Clinical decision making in the recognition of dying: a qualitative interview study.

    PubMed

    Taylor, Paul; Dowding, Dawn; Johnson, Miriam

    2017-01-25

    Recognising dying is an essential clinical skill for general and palliative care professionals alike. Despite the high importance, both identification and good clinical care of the dying patient remains extremely difficult and often controversial in clinical practice. This study aimed to answer the question: "What factors influence medical and nursing staff when recognising dying in end-stage cancer and heart failure patients?" This study used a descriptive approach to decision-making theory. Participants were purposively sampled for profession (doctor or nurse), specialty (cardiology or oncology) and grade (senior vs junior). Recruitment continued until data saturation was reached. Semi-structured interviews were conducted with NHS medical and nursing staff in an NHS Trust which contained cancer and cardiology tertiary referral centres. An interview schedule was designed, based on decision-making literature. Interviews were audio-recorded and transcribed and analysed using thematic framework. Data were managed with Atlas.ti. Saturation was achieved with 19 participants (7 seniors; 8 intermediate level staff; 4 juniors). There were 11 oncologists (6 doctors, 5 nurses) and 8 cardiologists (3 doctors, 5 nurses). Six themes were generated: information used; decision processes; modifying factors; implementation; reflecting on decisions and related decisions. The decision process described was time-dependent, ongoing and iterative, and relies heavily on intuition. This study supports the need to recognise the strengths and weaknesses of expertise and intuition as part of the decision process, and of placing the recognition of dying in a time-dependent context. Clinicians should also be prepared to accept and convey the uncertainty surrounding these decisions, both in practice and in communication with patients and carers.

  8. Aruna Shanbaug and the right to die with dignity: the battle continues.

    PubMed

    Kishore, R R

    2016-01-01

    Aruna Shanbaug's protracted continuance in a persistent vegetative state (PVS) for nearly 42 years needs to be viewed seriously by all those who believe in a person's inalienable right to dignity in dying. A terminally ill and/or incapacitated individual is a helpless person confronted with perpetual risk of intrusion in to his autonomy by the moral paternalists, owing to false notion of human virtues. Legislative inadequacy coupled with judicial heterogeneity has exposed the decision making process to unwarranted ambiguity. Misapplication of moral and juristic principles is a global challenge. 29-year-old Brittany Maynard's recent act of ending her life by migrating from California to Oregon has ignited a fierce debate and nearly half of the states in the USA are contemplating enactment of death with dignity legislation. Across the Atlantic, the European Court of Human Rights judgment on June 5, 2015, endorsing Vincent Lambert's right to end medical support, is a resounding affirmation of an individual's right to die with dignity. This article is an attempt to explore various dimensions of one's right to dignity in dying, in the global as well as the Indian context.

  9. East Asian Attitudes toward Death— A Search for the Ways to Help East Asian Elderly Dying in Contemporary America

    PubMed Central

    Lee, Sok K

    2009-01-01

    The art of dying well has been a quintessential subject of ethicoreligious matters among the people in the West and the East. Most of us wish to die at home; however, about 50% of Americans die in acute care hospitals. Furthermore, immigrants from East Asian cultures feel more uncomfortable near death, because their physicians are not familiar with their traditions. This article is written to help American physicians understand the unique aspects of East Asian Confucian Ethics for the better care of the dying elderly. Western attitudes toward death are briefly reviewed and the six East Asian concepts related to death are elaborated from Confucian Chinese philosophy. To widen the horizon of bioethics and to embrace the Confucian wisdom of dying well, three pearls of wisdom from classical Confucianism are proposed: the relational autonomy of family, Confucian creative self-transformation, and the unity of transcendence and the human being. PMID:20740092

  10. Development of processing diagrams for polymeric die attach adhesives

    NASA Astrophysics Data System (ADS)

    Hsiung, Jen-Chou

    With a processing diagram, one can reduce the effort required to customize curing process conditions for polymeric die attach adhesives. Polymeric die attach adhesives are often cured per the manufacturer's recommendations during initial screening evaluations. In most cases, the recommended cure schedules have to be modified so as to fit differences in process equipment. Unfortunately, the modified cure schedule is usually determined by a trial-and-error method. An aim of our experiments is to understand the curing process of a wide range of polymeric die attach adhesives (conventional, fast, and snap cure adhesives) and to construct a processing diagram, i.e., "Bondability Diagram", so as to define the processing window. Such diagrams should be helpful in determining both the time and cure temperature required to produce high quality bonds. The bondability diagram can be constructed based on fundamental understandings of the phenomena involved in the curing process using a wide variety of tools. Differential Scanning Calorimetry (DSC) is utilized to study the cure kinetics and the extent of reaction. Dynamic Mechanical Analysis (DMA) is used to determine gelation times and melt viscosity under a shear mode. A modified Rheovibron is employed to perform cure characterizations under a tensile mode so that cure stresses could be determined. Thermogravimetric Analysis (TGA) is used to evaluate the outgassing phenomena. Optical Microscopy (OM) is used to detect voids. Results indicate that the cure behaviors of conventional, fast, and snap cure adhesives are different in several respects. The combination of DSC, DMA, TGA, OM, and lap shear test leads to a frame work of developing the bondability diagram concept. The bondability diagram concept provides a foundation for an understanding of the recommended cure schedule and allows one to design their own cure schedule.

  11. Non-Employment Histories of Middle-Aged Men and Women Who Died from Alcohol-Related Causes: A Longitudinal Retrospective Study

    PubMed Central

    Paljärvi, Tapio; Martikainen, Pekka; Leinonen, Taina; Pensola, Tiina; Mäkelä, Pia

    2014-01-01

    Background Long-term patterning of non-employment among problem drinkers is poorly understood. We determined the level and timing of non-employment, and the relative contribution of various types of non-employment among middle-aged persons who died of alcohol-related causes. Methods We conducted a longitudinal retrospective register-based study of Finnish men and women aged 45–64 years who died of alcohol-related causes (n = 15 552) or other causes (n = 39 166) in the period 2000–07, or who survived (n = 204 422) until the end of 2007. We traced back the number of days in employment and non-employment for up to 17 years before death or before the end of the study period for the survivors. Results The majority (≥56%) of persons who died of alcohol-related causes were in employment up to ten years before death. Over the 17-year period before death, those who died of alcohol-related causes were in employment on average two years less (mean 6.3 years, 95%CI 6.2–6.4) than those dying of other causes (8.2, 8.1–8.3), and five years less than survivors (11.6, 11.5–11.7), when sex and age were adjusted for. The relative role of various types of non-employment differed markedly across the two mortality groups. Among those who died of alcohol-related causes, unemployment accounted for 54% of the total burden of non-employment, in comparison with 29% among those who died of other causes. In contrast, disability pension accounted for 41% of the total burden of non-employment among those who died of alcohol-related causes, but 65% among those who died of other causes. Conclusions The results indicate the feasibility of preventing movement out of employment among middle-aged men and women with severe alcohol-related harm, provided that they are identified early on during their working careers and offered effective interventions. PMID:24874518

  12. Enabling Quantitative Optical Imaging for In-die-capable Critical Dimension Targets

    PubMed Central

    Barnes, B.M.; Henn, M.-A.; Sohn, M. Y.; Zhou, H.; Silver, R. M.

    2017-01-01

    Dimensional scaling trends will eventually bring semiconductor critical dimensions (CDs) down to only a few atoms in width. New optical techniques are required to address the measurement and variability for these CDs using sufficiently small in-die metrology targets. Recently, Qin et al. [Light Sci Appl, 5, e16038 (2016)] demonstrated quantitative model-based measurements of finite sets of lines with features as small as 16 nm using 450 nm wavelength light. This paper uses simulation studies, augmented with experiments at 193 nm wavelength, to adapt and optimize the finite sets of features that work as in-die-capable metrology targets with minimal increases in parametric uncertainty. A finite element based solver for time-harmonic Maxwell's equations yields two- and three-dimensional simulations of the electromagnetic scattering for optimizing the design of such targets as functions of reduced line lengths, fewer number of lines, fewer focal positions, smaller critical dimensions, and shorter illumination wavelength. Metrology targets that exceeded performance requirements are as short as 3 μm for 193 nm light, feature as few as eight lines, and are extensible to sub-10 nm CDs. Target areas measured at 193 nm can be fifteen times smaller in area than current state-of-the-art scatterometry targets described in the literature. This new methodology is demonstrated to be a promising alternative for optical model-based in-die CD metrology. PMID:28757674

  13. Depression in the context of disability and the "right to die".

    PubMed

    Gill, Carol J

    2004-01-01

    Arguments in favor of legalized assisted suicide often center on issues of personal privacy and freedom of choice over one's body. Many disability advocates assert, however, that autonomy arguments neglect the complex sociopolitical determinants of despair for people with disabilities. Specifically, they argue that social approval of suicide for individuals with irreversible conditions is discriminatory and that relaxing restrictions on assisted suicide would jeopardize, not advance, the freedom of persons with disabilities to direct the lives they choose. This paper examines the idea promoted by some proponents of assisted suicide that it is reasonable to be depressed about one's diminished quality of life in cases of irreversible illness or disability and, therefore, such depression should not call into question the individual's competence to request assistance in dying. The concept of rational depression is defined and examined in the context of: four real-life cases involving individuals with disabilities who requested assistance in dying; a set of criteria commonly applied to decision-making to determine rationality; and research bearing on the emotional status of people with disabilities. It is concluded that although disability is associated with particular socially mediated stressors, there is no theoretical or empirical evidence to indicate that depression and its role in the "right to die" is dynamically different, more natural, or more reasonable for disabled people than for non-disabled people.

  14. Rapid Prototyping of Slot Die Devices for Roll to Roll Production of EL Fibers

    PubMed Central

    Bellingham, Alyssa; Bromhead, Nicholas; Fontecchio, Adam

    2017-01-01

    There is a growing interest in fibers supporting optoelectrical properties for textile and wearable display applications. Solution-processed electroluminescent (EL) material systems can be continuously deposited onto fiber or yarn substrates in a roll-to-roll process, making it easy to scale manufacturing. It is important to have precise control over layer deposition to achieve uniform and reliable light emission from these EL fibers. Slot-die coating offers this control and increases the rate of EL fiber production. Here, we report a highly adaptable, cost-effective 3D printing model for developing slot dies used in automatic coating systems. The resulting slot-die coating system enables rapid, reliable production of alternating current powder-based EL (ACPEL) fibers and can be adapted for many material systems. The benefits of this system over dip-coating for roll-to-roll production of EL fibers are demonstrated in this work. PMID:28772954

  15. Rapid Prototyping of Slot Die Devices for Roll to Roll Production of EL Fibers.

    PubMed

    Bellingham, Alyssa; Bromhead, Nicholas; Fontecchio, Adam

    2017-05-29

    There is a growing interest in fibers supporting optoelectrical properties for textile and wearable display applications. Solution-processed electroluminescent (EL) material systems can be continuously deposited onto fiber or yarn substrates in a roll-to-roll process, making it easy to scale manufacturing. It is important to have precise control over layer deposition to achieve uniform and reliable light emission from these EL fibers. Slot-die coating offers this control and increases the rate of EL fiber production. Here, we report a highly adaptable, cost-effective 3D printing model for developing slot dies used in automatic coating systems. The resulting slot-die coating system enables rapid, reliable production of alternating current powder-based EL (ACPEL) fibers and can be adapted for many material systems. The benefits of this system over dip-coating for roll-to-roll production of EL fibers are demonstrated in this work.

  16. Differential Die-Away Instrument: Report on Fuel Assembly Mock-up Measurements with Neutron Generator

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Goodsell, Alison Victoria; Swinhoe, Martyn Thomas; Henzl, Vladimir

    2014-09-18

    Fresh fuel experiments for the differential die-away (DDA) project were performed using a DT neutron generator, a 15x15 PWR fuel assembly, and nine 3He detectors in a water tank inside of a shielded cell at Los Alamos National Laboratory (LANL). Eight different fuel enrichments were created using low enriched (LEU) and depleted uranium (DU) dioxide fuel rods. A list-mode data acquisition system recorded the time-dependent signal and analysis of the DDA signal die-away time was performed. The die-away time depended on the amount of fissile material in the fuel assembly and the position of the detector. These experiments were performedmore » in support of the spent nuclear fuel Next Generation Safeguards Initiative DDA project. Lessons learned from the fresh fuel DDA instrument experiments and simulations will provide useful information to the spent fuel project.« less

  17. Melt fracture of linear low-density polyethylenes: Die geometry and molecular weight characteristics

    NASA Astrophysics Data System (ADS)

    Ebrahimi, Marzieh; Tomkovic, Tanja; Liu, Guochang; Doufas, Antonios A.; Hatzikiriakos, Savvas G.

    2018-05-01

    The melt fracture phenomena of three linear low-density polyethylenes are investigated as a function of die geometry (capillary, slit, and annular) and molecular weight and its distribution. The onset of melt fracture instabilities is determined by using capillary rheometry, mainly studying the extrudate appearance using optical microscopy. It is found that the onset of flow instabilities (melt fracture phenomena) is significantly affected by die geometry and molecular weight characteristics of the polymers. Use of annular die eliminates the stick-slip transition (oscillating melt fracture) and delays the onset of sharkskin to higher values of shear rate and shear stress. Moreover, it is shown that the molecular weight characteristics of the polymers are well correlated with critical conditions for the onset of flow instabilities based on a criterion proposed in the literature [A. Allal et al., "Relationships between molecular structure and sharkskin defect for linear polymers," J. Non-Newtonian Fluid Mech. 134, 127-135 (2006) and A. Allal and B. Vergnes, "Molecular design to eliminate sharkskin defect for linear polymers," J. Non-Newtonian Fluid Mech. 146, 45-50 (2007)].

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

    PubMed

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

    2014-10-01

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

  19. Recent tree die-off has little effect on streamflow in contrast to expected increases from historical studies

    NASA Astrophysics Data System (ADS)

    Biederman, Joel A.; Somor, Andrew J.; Harpold, Adrian A.; Gutmann, Ethan D.; Breshears, David D.; Troch, Peter A.; Gochis, David J.; Scott, Russell L.; Meddens, Arjan J. H.; Brooks, Paul D.

    2015-12-01

    Recent bark beetle epidemics have caused regional-scale tree mortality in many snowmelt-dominated headwater catchments of western North America. Initial expectations of increased streamflow have not been supported by observations, and the basin-scale response of annual streamflow is largely unknown. Here we quantified annual streamflow responses during the decade following tree die-off in eight infested catchments in the Colorado River headwaters and one nearby control catchment. We employed three alternative empirical methods: (i) double-mass comparison between impacted and control catchments, (ii) runoff ratio comparison before and after die-off, and (iii) time-trend analysis using climate-driven linear models. In contrast to streamflow increases predicted by historical paired catchment studies and recent modeling, we did not detect streamflow changes in most basins following die-off, while one basin consistently showed decreased streamflow. The three analysis methods produced generally consistent results, with time-trend analysis showing precipitation was the strongest predictor of streamflow variability (R2 = 74-96%). Time-trend analysis revealed post-die-off streamflow decreased in three catchments by 11-29%, with no change in the other five catchments. Although counter to initial expectations, these results are consistent with increased transpiration by surviving vegetation and the growing body of literature documenting increased snow sublimation and evaporation from the subcanopy following die-off in water-limited, snow-dominated forests. The observations presented here challenge the widespread expectation that streamflow will increase following beetle-induced forest die-off and highlight the need to better understand the processes driving hydrologic response to forest disturbance.

  20. Assessing the Quality of Death and Dying in an Integrated Health Care System in Rural Pennsylvania.

    PubMed

    Darer, Jonathan D; Clarke, Deseraé N; Sees, Amanda C; Berger, Andrea L; Kirchner, H Lester; Stametz, Rebecca A; Davis, Daniel

    2015-09-01

    With growing emphasis on improving the value of health care, there is increased scrutiny of quality outcomes and high health expenditures during the final months of life. The purpose of this project is to answer 1) how do next of kin (NOK) perceive the quality of their loved ones' dying and death; 2) are there patient and NOK characteristics that predict lower quality; and 3) are there structural aspects of care associated with lower quality? A mailed survey was administered to a stratified random sample of NOK of Geisinger Health System patients who had died in the past year. The Quality of Death and Dying, the General Anxiety Disorder seven-item scale, the Patient Health Questionnaire eight-item depression scale, and selected questions from the Toolkit of Instruments to Measure End of Life Care were used. There were 672 respondents. Significant predictors of Quality of Death and Dying score were number of doctors involved in care (P = 0.0415), location of death (P < 0.0001), frequency of receiving confusing or contradictory information (P < 0.0001), illness progression (P = 0.0343), Patient Health Questionnaire-2 score (P = 0.0148), and General Anxiety Disorder seven-item scale score (P < 0.0070). Several findings suggest that factors such as NOK depression and anxiety, prolonged illness, dying in the hospital, receipt of conflicting information, and confusion around the doctor in charge are associated with lower quality of the dying and death experience for NOK. Further investigation is warranted to facilitate high-quality measurement and the use of measurement results to improve care. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  1. Teaching Residents How to Talk About Death and Dying: A Mixed-Methods Analysis of Barriers and Randomized Educational Intervention.

    PubMed

    Miller, David C; Sullivan, Amy M; Soffler, Morgan; Armstrong, Brett; Anandaiah, Asha; Rock, Laura; McSparron, Jakob I; Schwartzstein, Richard M; Hayes, Margaret M

    2018-01-01

    We present a pilot study exploring the effects of a brief, 30-minute educational intervention targeting resident communication surrounding dying in the intensive care unit (ICU). We sought to determine whether simulation or didactic educational interventions improved resident-reported comfort, preparation, and skill acquisition. We also sought to identify resident barriers to using the word "dying." In this mixed-methods prospective study, second- and third-year medical residents were randomized to participate in a simulation-based communication training or a didactic session. Residents completed a pre-post survey after the sessions evaluating the sessions and reflecting on their use of the word "dying" in family meetings. Forty-five residents participated in the study. Residents reported increases in comfort (Mean [M]-pre = 3.3 [standard deviation: 0.6], M-post = 3.7 [0.7]; P < .01, Cohen d = 0.75) and preparation (M-pre = 3.4 [0.7], M-post = 3.9 [0.6]; P < .01, d = 1.07) using the word "dying" after both the simulation and didactic versions. Residents randomized to the simulation reported they were more likely to have learned new skills as compared to residents in the didactic (M-simulation = 2.2 [0.4], M-didactic = 1.9 [0.3]; P = .015, d = 0.80). They estimated that they used the word "dying" in 50% of their end-of-life (EOL) conversations and identified uncertain prognosis as the main barrier to explicitly stating the word "dying." A 30-minute educational intervention improves internal medicine residents' self-reported comfort and preparation in talking about death and dying in the ICU. Residents in simulation-based training were more likely to report they learned new skills as compared to the didactic session. Residents report multiple barriers to using the word "dying" EOL conversations.

  2. Exposure of trees to drought-induced die-off is defined by a common climatic threshold across different vegetation types

    PubMed Central

    Mitchell, Patrick J; O'Grady, Anthony P; Hayes, Keith R; Pinkard, Elizabeth A

    2014-01-01

    Increases in drought and temperature stress in forest and woodland ecosystems are thought to be responsible for the rise in episodic mortality events observed globally. However, key climatic drivers common to mortality events and the impacts of future extreme droughts on tree survival have not been evaluated. Here, we characterize climatic drivers associated with documented tree die-off events across Australia using standardized climatic indices to represent the key dimensions of drought stress for a range of vegetation types. We identify a common probabilistic threshold associated with an increased risk of die-off across all the sites that we examined. We show that observed die-off events occur when water deficits and maximum temperatures are high and exist outside 98% of the observed range in drought intensity; this threshold was evident at all sites regardless of vegetation type and climate. The observed die-off events also coincided with at least one heat wave (three consecutive days above the 90th percentile for maximum temperature), emphasizing a pivotal role of heat stress in amplifying tree die-off and mortality processes. The joint drought intensity and maximum temperature distributions were modeled for each site to describe the co-occurrence of both hot and dry conditions and evaluate future shifts in climatic thresholds associated with the die-off events. Under a relatively dry and moderate warming scenario, the frequency of droughts capable of inducing significant tree die-off across Australia could increase from 1 in 24 years to 1 in 15 years by 2050, accompanied by a doubling in the occurrence of associated heat waves. By defining commonalities in drought conditions capable of inducing tree die-off, we show a strong interactive effect of water and high temperature stress and provide a consistent approach for assessing changes in the exposure of ecosystems to extreme drought events. PMID:24772285

  3. Caring for dying cancer patients in the Chinese cultural context: A qualitative study from the perspectives of physicians and nurses.

    PubMed

    Dong, Fengqi; Zheng, Ruishuang; Chen, Xuelei; Wang, Yanhui; Zhou, Hongyuan; Sun, Rong

    2016-04-01

    To explore the experiences of Chinese physicians and nurses who care for dying cancer patients in their practical work. This was a qualitative study using semi-structured face-to-face interviews. Fifteen physicians and 22 nurses were recruited from a cancer center in mainland China. The data were analyzed by qualitative thematic analysis. Disclosure of information on death and cancer to dying cancer patients is taboo in traditional Chinese culture, which greatly decreases the physicians' and nurses' effective communication with dying patients in end-of-life (EOL) care. Both physicians and nurses described strong ambitions to give dying cancer patients high-quality care, and they emphasized the importance of maintaining dying patients' hopes in the death-denying cultural context. However, the nurses were more concerned with dying patients' physical comfort and wish fulfillment, while the physicians placed greatest emphasis on patients' rights and symptom management. Both physicians and nurses suffered whilst also benefitting from taking care of dying patients which helped with their personal growth and allowed greater insight into themselves and their clinical practice. Our results also indicated that Chinese physicians and nurses require improved methods of communication on EOL care, as well as needing more support to provide quality EOL care. Chinese physicians and nurses experience a challenge when caring for dying cancer patients in the Chinese cultural context. Flexible and specific education and training in EOL cancer care are required to meet the needs of Chinese physicians and nurses at the cancer center studied. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. 75 FR 11914 - Chrysler, LLC, Mount Elliott Tool and Die, Including On-Site Leased Workers From Modern...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ... Elliott Tool and Die, Including On-Site Leased Workers From Modern Professional Services, TAC Automotive... on-site leased workers from Modern Professional Services, TAC Automotive, Syncreon, CSC, and Resource... subject firm. The workers are engaged in the production of automotive dies and tooling. New information...

  5. Premortem interventions in dying children to optimise organ donation: an ethical analysis.

    PubMed

    Brierley, Joe; Shaw, David

    2016-07-01

    A range of interventions in dying patients can improve both the possibility of successful organ donation and the likely long-term success of transplantation. The ethical and legal issues surrounding such interventions, which most frequently occur in the context of donation after circulatory determination of death, are complex, controversial and many remain unresolved. This is true with adults, but even more so with children, where the issue of organ donation and premortem interventions to facilitate it, are highly sensitive. Essentially, such interventions are being undertaken in dying children who cannot medically benefit from them, though arguments have been advanced that becoming a donor might be in a child's extended best interest. However, certain interventions carry a potential risk, although small, of direct harm and of course overall objections to child donation after circulatory determination of death per se are still expressed in the literature. But, unlike the case in critically ill adults, those giving permission for such interventions are normally able to fully participate in decision-making, and indeed to consent, to both donation and premortem interventions. We review the issue of the use of premortem interventions in dying children to facilitate organ donation, including decision-making and ethical justification. Individual interventions are then considered, including an ethical analyse of their use. Finally, we recommend an approach using a combination of welfare checklist strategy, coupled with the establishment of an agreed zone of parental discretion about individual interventions which might be used in dying children to increase the possibility of successful organ donation. 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/

  6. Dying with dementia: symptom burden, quality of care, and place of death.

    PubMed

    Pinzon, Luis Carlos Escobar; Claus, Matthias; Perrar, Klaus Maria; Zepf, Kirsten Isabel; Letzel, Stephan; Weber, Martin

    2013-03-01

    No detailed information has been available until now about the care setting, circumstances and place of death, symptom burden, and quality of care of persons with end-stage dementia in Germany. This cross-sectional study is based on a random sample of 5000 persons who died in the period from 25 May to 24 August 2008 in the German federal state of Rhineland-Palatinate. Their surviving relatives were contacted and asked to participate in a questionnaire survey. Data were obtained in this way for 310 persons with dementia and 931 persons without dementia. 42.4% of the persons with dementia died at home. Most patients and their relatives preferred death at home to death anywhere else (94.8% of patients, 77.5% of relatives). Persons living with at least one relative were more likely to die at home (adjusted odds ratio [aOR] 4.69, 95% confidence interval [CI] 2.71-8.11). According to information supplied by the relatives, the overwhelming majority of patients suffered, two days before death, from moderate to severe weakness (94.9%), fatigue (94.4%), disorientation/confusion (86.9%), and appetite loss (86.4%). Other common symptoms were anxiety (61.0%), tension (59.9%), dyspnea (56.7%), and pain (52.5%). The relatives were critical of the quality of care on standard hospital wards, citing the limited temporal availability of staff and limited emotional support. These data indicate the high symptom burden of persons with dementia in Germany at the end of their lives. They underscore the need for proper palliative care in all of the settings where persons with dementia die. Specialized in- and outpatient palliative care should not be offered only to patients with cancer, but should rather be made available to all who need it.

  7. Laser micromilling of convex microfluidic channels onto glassy carbon for glass molding dies

    NASA Astrophysics Data System (ADS)

    Tseng, Shih-Feng; Chen, Ming-Fei; Hsiao, Wen-Tse; Huang, Chien-Yao; Yang, Chung-Heng; Chen, Yu-Sheng

    2014-06-01

    This study reports the fabrication of convex microfluidic channels on glassy carbon using an ultraviolet laser processing system to produce glass molding dies. The laser processing parameters, including various laser fluences and scanning speeds of galvanometers, were adjusted to mill a convex microchannel on a glassy carbon substrate to identify the effects of material removal. The machined glassy carbon substrate was then applied as a glass molding die to fabricate a glass-based microfluidic biochip. The surface morphology, milled width and depth, and surface roughness of the microchannel die after laser micromilling were examined using a three-dimensional confocal laser scanning microscope. This study also investigates the transcription rate of microchannels after the glass molding process. To produce a 180 μm high microchannel on the GC substrate, the optimal number of milled cycles, laser fluence, and scanning speed were 25, 4.9 J/cm2, and 200 mm/s, respectively. The width, height, and surface roughness of milled convex microchannels were 119.6±0.217 μm, 180.26±0.01 μm, and 0.672±0.08 μm, respectively. These measured values were close to the predicted values and suitable for a glass molding die. After the glass molding process, a typical glass-based microchannel chip was formed at a molding temperature of 660 °C and the molding force of 0.45 kN. The transcription rates of the microchannel width and depth were 100% and 99.6%, respectively. Thus, the proposed approach is suitable for performing in chemical, biochemical, or medical reactions.

  8. Learning About Dying and Living: An Applied Approach to End-of-Life Communication.

    PubMed

    Pagano, Michael P

    2016-08-01

    The purpose of this article is to expand on prior research in end-of-life communication and death and dying communication apprehension, by developing a unique course that utilizes a hospice setting and an applied, service-learning approach. Therefore, this essay describes and discusses both students' and my experiences over a 7-year period from 2008 through 2014. The courses taught during this time frame provided an opportunity to analyze students' responses, experiences, and discoveries across semesters/years and cocultures. This unique, 3-credit, 14-week, service-learning, end-of-life communication course was developed to provide an opportunity for students to learn the theories related to this field of study and to apply that knowledge through volunteer experiences via interactions with dying patients and their families. The 7 years of author's notes, plus the 91 students' electronically submitted three reflection essays each (273 total documents) across four courses/years, served as the data for this study. According to the students, verbally in class discussions and in numerous writing assignments, this course helped lower their death and dying communication apprehension and increased their willingness to interact with hospice patients and their families. Furthermore, the students' final research papers clearly demonstrated how utilizing a service-learning approach allowed them to apply classroom learnings and interactions with dying patients and their families at the hospice, to their analyses of end-of-life communication theories and behaviors. The results of these classes suggest that other, difficult topic courses (e.g., domestic violence, addiction, etc.) might benefit from a similar pedagogical approach.

  9. Evolution of the Die-Wall Pressure during the Compression of Biconvex Tablets: Experimental Results and Comparison with FEM Simulation.

    PubMed

    Mazel, Vincent; Diarra, Harona; Busignies, Virginie; Tchoreloff, Pierre

    2015-12-01

    Capping is a classical manufacturing problem for tablets, which is known to affect more biconvex tablets than flat-faced ones. One reason could be the development of a higher residual die-wall pressure during unloading. Unfortunately, contradictory results were published on the subject. In this work, the evolution of the die-wall pressure during the compaction of biconvex tablets was studied experimentally and using finite element method (FEM) modeling. It was compared with the case of flat-faced tablets. Experimental and numerical results showed that during the compression of biconvex tablet, a lower maximum die-wall pressure and a higher residual die-wall pressure were obtained compared with the case of flat-faced tablet. Moreover, both approaches showed, for biconvex tablets, a temporary increase of the die-wall pressure at the end of the unloading phase. FEM demonstrated that this phenomenon was due to a gradual loss of contact between the punch and the tablet from the side to the center. This complex unloading behavior causes the temporary increase of the die-wall pressure and the development of a shear stress between the convex part and the land of the tablet. This could explain the capping tendency of biconvex tablets. © 2015 Wiley Periodicals, Inc. and the American Pharmacists Association.

  10. UO2 fuel pellets fabrication via Spark Plasma Sintering using non-standard molybdenum die

    NASA Astrophysics Data System (ADS)

    Papynov, E. K.; Shichalin, O. O.; Mironenko, A. Yu; Tananaev, I. G.; Avramenko, V. A.; Sergienko, V. I.

    2018-02-01

    The article investigates spark plasma sintering (SPS) of commercial uranium dioxide (UO2) powder of ceramic origin into highly dense fuel pellets using non-standard die instead of usual graphite die. An alternative and formerly unknown method has been suggested to fabricate UO2 fuel pellets by SPS for excluding of typical problems related to undesirable carbon diffusion. Influence of SPS parameters on chemical composition and quality of UO2 pellets has been studied. Also main advantages and drawbacks have been revealed for SPS consolidation of UO2 in non-standard molybdenum die. The method is very promising due to high quality of the final product (density 97.5-98.4% from theoretical, absence of carbon traces, mean grain size below 3 μm) and mild sintering conditions (temperature 1100 ºC, pressure 141.5 MPa, sintering time 25 min). The results are interesting for development and probable application of SPS in large-scale production of nuclear ceramic fuel.

  11. Predicting Tree Mortality Die-off Events Associated with Hotter Drought and Assessing Their Global Consequences via Ecoclimate Teleconnections.

    NASA Astrophysics Data System (ADS)

    Breshears, D. D.; Allen, C. D.; McDowell, N. G.; Adams, H. D.; Barnes, M.; Barron-Gafford, G.; Bradford, J. B.; Cobb, N.; Field, J. P.; Froend, R.; Fontaine, J. B.; Garcia, E.; Hardy, G. E. S. J.; Huxman, T. E.; Kala, J.; Lague, M. M.; Martinez-Yrizar, A.; Matusick, G.; Minor, D. M.; Moore, D. J.; Ng, M.; Ruthrof, K. X.; Saleska, S. R.; Stark, S. C.; Swann, A. L. S.; Villegas, J. C.; Williams, A. P.; Zou, C.

    2017-12-01

    Evidence that tree mortality is increasingly likely occur in extensive die-off events across the terrestrial biosphere continues to mount. The consequences of such extensive mortality events are potentially profound, not only for the locations where die-off events occur, but also for other locations that could be impacted via ecoclimate teleconnections, whereby the land surface changes associated with die-off in one location could alter atmospheric circulation patterns and affect vegetation elsewhere. Here, we (1) recap the background of tree mortality as an emerging environmental issue, (2) highlight recent advances that could help us improve predictions of the vulnerability to tree mortality, including the underlying importance of hydraulic failure, the potential to develop climatic envelopes specific to tree mortality events, and consideration of the role of heat waves; and (3) initial bounding simulations that indicate the potential for tree die-off events in different locations to alter ecoclimate teleconnections. As we move toward globally coordinated carbon accounting and management, the high vulnerability to tree die-off events and the potential for such events to affect vegetation elsewhere will both need to be accounted for.

  12. Hubble's View of a Dying Star

    NASA Technical Reports Server (NTRS)

    2003-01-01

    A recent image of a dying star containing strange, complex structures may help explain the death throes of stars and defy our current understanding of physics. The image of protoplanetary nebula IRAS22036+5306 (in the Infrared Astronomical Satellite Point Source Catalog) was taken on Dec. 15, 2001, by the Wide Field and Planetary Camera 2, designed and built by NASA's Jet Propulsion Laboratory, onboard NASA's Hubble Space Telescope. It is one of the best images yet to capture a fleeting period at the end of a Sun-like star's life, called the protoplanetary nebula phase.

    This phase, which looks like a beautiful cloud of glowing gas lit up by ultraviolet light from the star's core, results when a star evolves into a bloated red giant and sheds its outer layers. 'Protoplanetary nebulas are rare objects with short lifetimes,' said JPL astrophysicist Dr. Raghvendra Sahai. 'It has generally been very difficult to obtain images of such objects in which their structure can be resolved in detail.'

    This image is particularly important because it contains a series of what Sahai and his colleagues call 'knotty jets,' blob-like objects emerging along roughly straight lines from the center of the cigar-shaped, bipolar nebula (See insets). There are various theories about what may produce such jets, though it is hard to prove their existence due to their short-lived, episodic nature. Detailed multi-wavelength studies of these nebulas with NASA's Great Observatories are being carried out to understand the nature and origin of these enigmatic jets, and how they may be sculpting shrouds of dying stars into exotic shapes. The Hubble Space Telescope is one of NASA's Great Observatories.

  13. On-Die Sensors for Transient Events

    NASA Astrophysics Data System (ADS)

    Suchak, Mihir Vimal

    Failures caused by transient electromagnetic events like Electrostatic Discharge (ESD) are a major concern for embedded systems. The component often failing is an integrated circuit (IC). Determining which IC is affected in a multi-device system is a challenging task. Debugging errors often requires sophisticated lab setups which require intentionally disturbing and probing various parts of the system which might not be easily accessible. Opening the system and adding probes may change its response to the transient event, which further compounds the problem. On-die transient event sensors were developed that require relatively little area on die, making them inexpensive, they consume negligible static current, and do not interfere with normal operation of the IC. These circuits can be used to determine the pin involved and the level of the event in the event of a transient event affecting the IC, thus allowing the user to debug system-level transient events without modifying the system. The circuit and detection scheme design has been completed and verified in simulations with Cadence Virtuoso environment. Simulations accounted for the impact of the ESD protection circuits, parasitics from the I/O pin, package and I/O ring, and included a model of an ESD gun to test the circuit's response to an ESD pulse as specified in IEC 61000-4-2. Multiple detection schemes are proposed. The final detection scheme consists of an event detector and a level sensor. The event detector latches on the presence of an event at a pad, to determine on which pin an event occurred. The level sensor generates current proportional to the level of the event. This current is converted to a voltage and digitized at the A/D converter to be read by the microprocessor. Detection scheme shows good performance in simulations when checked against process variations and different kind of events.

  14. Predominant bacteria isolated from moribund Fusconaia ebena ebonyshells experiencing die-offs in Pickwick Reservoir, Tennessee River, Alabama

    USGS Publications Warehouse

    Starliper, C.E.; Powell, J.; Garner, J.T.; Schill, W.B.

    2011-01-01

    Mussel die-offs have been noted in recent years in Pickwick Reservoir, Tennessee River, Alabama. The primary affected species was Fusconaia ebena, but also affected to lesser degrees were Ellipsaria lineolata, Quadrula pustulosa, and Quadrula quadrula. These events were characterized by large numbers of empty shells—fresh-dead and live individuals that were presumed to be diseased because of weak and slow valve closure responses to external stimuli. Anecdotal evidence suggested the possible involvement of an etiological agent, such as a bacterial pathogen. The die-offs have occurred in Pickwick Reservoir (river miles 236–256) in sequential years during the past approximately 10 y. These timeframes have coincided with reduced basin inflows and warmer water temperatures. The majority of the moribund and freshly dead F. ebena were females possibly predisposed to infection and disease from ongoing reproductive activity. Affected and healthy-cohort mussels were collected to characterize the bacterial flora prior to, during, and after a July 2006 die-off, and during a subsequent die-off in September 2008. The numbers of total bacteria from both the 2006 and 2008 die-offs were significantly greater from the diseased specimens. For example, from the September 2008 die-off, the mean count from diseased F. ebena soft tissues was 9.75 × 106 cfu/g, which was more than 100 times greater (P = 0.025) than the mean from healthy cohorts (6.74 × 104 cfu/g). The predominant bacteria from affected F. ebena from July 2006 were Hafnia alvei and Aeromonas sobria, whereas from September 2008 the predominant bacteria were Enterobacter spp., Aeromonas schubertii, Aeromonas veronii bv. veronii, and Aeromonas veronii bv. sobria.

  15. Understandings of Death and Dying for People of Chinese Origin

    ERIC Educational Resources Information Center

    Hsu, Chiung-Yin; O'Connor, Margaret; Lee, Susan

    2009-01-01

    This article introduces the primary beliefs about ancestor worship, Taoism, Confucianism, Buddhism and traditional Chinese medicine that have influenced Chinese people for thousands of years, particularly in relation to death and dying. These cultures and traditions remain important for Chinese people wherever they live. Over a long period,…

  16. AGU Fellow Roger Revelle Dies

    NASA Astrophysics Data System (ADS)

    DeVito, M. Catherine

    AGU Fellow Roger R.D. Revelle, past Oceanography section president and recipient of the William Bowie Medal, died July 15. Revelle was a pioneer in global warming research and plate tectonics, and a major contributor to oceanography, education, and public policy.Appointed an AGU Fellow in 1936, Revelle was president of the Oceanography section from 1953-1956. In 1968 he was awarded the Bowie Medal, AGU's highest honor. Revelle extended his activities beyond the limits of his specialty to actively work with scientists in other fields for the betterment of science. In presenting the award, George E. Backus described Revelle's career as one of bold and selfless service to science and his fellow man. “If scientific progress is built on the shoulders of giants, Roger Revelle is certainly to be counted among the giants.”

  17. 20 CFR 404.284 - Recomputations for people who reach age 62, or become disabled, or die before age 62 after 1978.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., or become disabled, or die before age 62 after 1978. 404.284 Section 404.284 Employees' Benefits... who reach age 62, or become disabled, or die before age 62 after 1978. (a) General. Years of your... disabled or died before age 62. (e) Minimum increase in primary insurance amounts. Your primary insurance...

  18. 20 CFR 404.284 - Recomputations for people who reach age 62, or become disabled, or die before age 62 after 1978.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ..., or become disabled, or die before age 62 after 1978. 404.284 Section 404.284 Employees' Benefits... who reach age 62, or become disabled, or die before age 62 after 1978. (a) General. Years of your... disabled or died before age 62. (e) Minimum increase in primary insurance amounts. Your primary insurance...

  19. 20 CFR 404.284 - Recomputations for people who reach age 62, or become disabled, or die before age 62 after 1978.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., or become disabled, or die before age 62 after 1978. 404.284 Section 404.284 Employees' Benefits... who reach age 62, or become disabled, or die before age 62 after 1978. (a) General. Years of your... disabled or died before age 62. (e) Minimum increase in primary insurance amounts. Your primary insurance...

  20. 20 CFR 404.284 - Recomputations for people who reach age 62, or become disabled, or die before age 62 after 1978.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ..., or become disabled, or die before age 62 after 1978. 404.284 Section 404.284 Employees' Benefits... who reach age 62, or become disabled, or die before age 62 after 1978. (a) General. Years of your... disabled or died before age 62. (e) Minimum increase in primary insurance amounts. Your primary insurance...

  1. 20 CFR 404.284 - Recomputations for people who reach age 62, or become disabled, or die before age 62 after 1978.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ..., or become disabled, or die before age 62 after 1978. 404.284 Section 404.284 Employees' Benefits... who reach age 62, or become disabled, or die before age 62 after 1978. (a) General. Years of your... disabled or died before age 62. (e) Minimum increase in primary insurance amounts. Your primary insurance...

  2. Survey on death and dying in Hong Kong: attitudes, beliefs, and preferred end-of-life care.

    PubMed

    Mjelde-Mossey, Lee Ann; Chan, Cecilia L W

    2007-01-01

    Social Workers in end-of-life and palliative care have a particular opportunity to ease the dying process by providing culturally appropriate services to the dying and their families. In today's multicultural social environment, with an ever-increasing immigrant population, social workers are challenged to be knowledgeable about diverse cultures. Recently, a forum of health care professionals and social workers in Hong Kong conducted a survey of the general population to assess death and dying attitudes, beliefs, and preferences for end-of-life care. Four-hundred-thirty Hong Kong Chinese participated in a telephone interview. Responses were compared by gender. The survey results not only contribute to an understanding of Hong Kong Chinese, but can inform social workers who practice with Chinese immigrants to the United States.

  3. Never say die: death euphemisms, misunderstandings and their implications for practice.

    PubMed

    Rawlings, Deborah; Tieman, Jennifer J; Sanderson, Christine; Parker, Deborah; Miller-Lewis, Lauren

    2017-07-02

    A Massive Open Online Course (MOOC) on death and dying was conducted to open the dialogue around death and dying. In one activity, participants were asked to engage with language and to think of alternative words (or euphemisms) that are used to describe death. To reflect from a nursing perspective how language enables and sometimes disguises important messages and conversations. Four hundred and seventy one participants provided 3053 euphemisms. Euphemisms were varied, with many providing commentary on their purpose and use. As a society we have become quite creative in the use of euphemisms, but need to be mindful of misunderstandings and misinterpretations which can cause embarrassment and distress in clinical situations. This paper describes some of the euphemisms that were provided, examining why they are used and how their use can be easily misconstrued in daily life and in clinical practice.

  4. Chinese cultural dimensions of death, dying, and bereavement: focus group findings.

    PubMed

    Yick, Alice G; Gupta, Rashmi

    2002-01-01

    The purpose of this qualitative study is to describe Chinese immigrants and Chinese Americans' attitudes and practices about death, dying, and bereavement. To this end, three focus groups were conducted with social work graduate students, pastors and religious leaders, and service providers working in the Chinese American community in New York City. The United States is becoming increasingly multicultural, and Chinese Americans are the most rapidly growing Asian American group. Findings from this study revealed that many Chinese attitudes and practices about death and dying are rooted in Asian cultural values such as filial piety, centrality of the family, and emphasis of hierarchy. In addition, strains of Confucianism, Buddhism, Taoism, and local folklore are embedded in these death attitudes and practices. Based on themes extrapolated from the focus groups, recommendations are delineated for service providers in order to implement culturally-sensitive bereavement practices.

  5. Fatigue properties of die cast zinc alloys for automotive lock applications

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Schrems, Karol K.; Dogan, Omer N.; Goodwin, F.E.

    2004-06-01

    During the 1970’s many automotive lock systems were converted from zinc die casting alloys to engineering plastics for reasons of weight and cost. Recent increases in requirements for precision and security have caused automotive and other lock designers to reconsider zinc alloy die-castings for these applications. To enable this, there is a need for mechanical property data comparable to that of the plastics materials used in these applications. In this work, rotary bending fatigue tests were performed on Alloys 3, 5, ZA-8 and AcuZinc 5 using an R.R. Moore fatigue machine. Testing was performed at 30 Hz and was stoppedmore » at 1x107 cycles. The fatigue limit results were compared to data reported in the literature for higher number of cycles and faster rotations.« less

  6. Should the patient be allowed to die? 1

    PubMed Central

    Nicholson, Richard

    1975-01-01

    In considering the patient's right to a certain quality of dying, this essay outlines how the legal and ethical justifications for passive euthanasia depend on the doctrine of acts and omissions. It is suggested that this doctrine is untenable and that alternative justifications are needed. The development of the modern mechanistic approach to death is traced, showing that a possible basis for an humane way of death lies in a reacceptance of a metaphysical concept of life. PMID:1100831

  7. Response to "Exploring the Religious-Spiritual Needs of the Dying."

    ERIC Educational Resources Information Center

    Holden, Janice Miner

    1993-01-01

    Responds to previous article by Douglas C. Smith on exploring the religious-spiritual needs of the dying in which Smith presents psychosocial tools than can be used to assess, examine, and amplify client's religious-spiritual strengths. Compares Smith's work to classic values clarification, addresses issues of counselor judgment and informed…

  8. Death and Dying as a Controversial Issue in Health Education.

    ERIC Educational Resources Information Center

    Russell, Robert D.; And Others

    1982-01-01

    Various perspectives on the inclusion of death education in health education curricula are offered. Discussed are: (1) positive and negative attitudes toward death; (2) teacher competence, qualifications, and skills; (3) religious beliefs about death; (4) Kubler-Ross's Five Stages of Dying; and (5) political implications of teaching about death.…

  9. Water-quality impacts from climate-induced forest die-off

    NASA Astrophysics Data System (ADS)

    Mikkelson, Kristin M.; Dickenson, Eric R. V.; Maxwell, Reed M.; McCray, John E.; Sharp, Jonathan O.

    2013-03-01

    Increased ecosystem susceptibility to pests and other stressors has been attributed to climate change, resulting in unprecedented tree mortality from insect infestations. In turn, large-scale tree die-off alters physical and biogeochemical processes, such as organic matter decay and hydrologic flow paths, that could enhance leaching of natural organic matter to soil and surface waters and increase potential formation of harmful drinking water disinfection by-products (DBPs). Whereas previous studies have investigated water-quantity alterations due to climate-induced, forest die-off, impacts on water quality are unclear. Here, water-quality data sets from water-treatment facilities in Colorado were analysed to determine whether the municipal water supply has been perturbed by tree mortality. Results demonstrate higher total organic carbon concentrations along with significantly more DBPs at water-treatment facilities using mountain-pine-beetle-infested source waters when contrasted with those using water from control watersheds. In addition to this differentiation between watersheds, DBP concentrations demonstrated an increase within mountain pine beetle watersheds related to the degree of infestation. Disproportionate DBP increases and seasonal decoupling of peak DBP and total organic carbon concentrations further suggest that the total organic carbon composition is being altered in these systems.

  10. High electrical resistivity Nd-Fe-B die-upset magnet doped with eutectic DyF3-LiF salt mixture

    NASA Astrophysics Data System (ADS)

    Kim, K. M.; Kim, J. Y.; Kwon, H. W.; Kim, D. H.; Lee, J. G.; Yu, J. H.

    2017-05-01

    Nd-Fe-B-type die-upset magnet with high electrical resistivity was prepared by doping of eutectic DyF3-LiF salt mixture. Mixture of melt-spun Nd-Fe-B flakes (MQU-F: Nd13.6Fe73.6Co6.6Ga0.6B5.6) and eutectic binary (DyF3-LiF) salt (25 mol% DyF3 - 75 mol% LiF) was hot-pressed and then die-upset. By adding the eutectic salt mixture (> 4 wt%), electrical resistivity of the die-upset magnet was enhanced to over 400 μ Ω .cm compared to 190 μ Ω .cm of the un-doped magnet. Remarkable enhancement of the electrical resistivity was attributed to homogeneous and continuous coverage of the interface between flakes by the easily melted eutectic salt dielectric mixture. It was revealed that active substitution of the Nd atoms in neighboring flakes by the Dy atoms from the added (DyF3-LiF) salt mixture had occurred during such a quick thermal processing of hot-pressing and die-upsetting. This Dy substitution led to coercivity enhancement in the die-upset magnet doped with the eutectic (DyF3-LiF) salt mixture. Coercivity and remanence of the die-upset magnet doped with (DyF3-LiF) salt mixture was as good as those of the DyF3-doped magnet.

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

    PubMed

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

    2011-10-01

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

  12. Too lonely to die alone: internet suicide pacts and existential suffering in Japan.

    PubMed

    Ozawa-de Silva, Chikako

    2008-12-01

    Most striking in the recent rise of suicide in Japan are the increase in suicide among young Japanese and the emergence of Internet suicide pacts. An ethnography of suicide-related Web sites reveals a distinctive kind of existential suffering among visitors that is not reducible to categories of mental illness and raises questions regarding the meaning of an individual "choice" to die, when this occurs in the context of an intersubjective decision by a group of strangers, each of whom is too afraid to die alone. Anthropology's recent turn to subjectivity enables analyses of individual suffering in society that provide a more nuanced approach to the apparent dichotomy between agency and structure and that connect the phenomenon of suicide in Japan to Japanese conceptions of selfhood and the afterlife. The absence of ikigai [the worth of living] among suicide Web site visitors and their view of suicide as a way of healing show, furthermore, that analyses of social suffering must be expanded to include questions of meaning and loss of meaning and, also, draw attention to Japanese conceptions of self in which relationality in all things, including the choice to die, is of utmost importance.

  13. Process research into metallic pipe wear of hot chamber die casting machines and methods ofincreasing wear resistance

    NASA Astrophysics Data System (ADS)

    Mukhametzyanova, G. F.; Kolesnikov, MS; Mukhametzyanov, I. R.; Astatshenko, V. I.

    2017-09-01

    The kinetics and reasons for metallic pipe wear of hot chamberzinc alloy die casting machines are established.Increasing metallic pipe wear components wear resistance is being achieved by means of die steelДИ - 22 with electroslag remelting modification and electron-beamremelting modification and after the processes of nitriding and boriding besides.

  14. Clinical Criteria for Physician Aid in Dying.

    PubMed

    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.

  15. Live to die another way: modes of programmed cell death and the signals emanating from dying cells

    PubMed Central

    Fuchs, Yaron; Steller, Hermann

    2015-01-01

    Preface All life ends in death, but perhaps one of life’s grander ironies is that it also depends on death. Cell-intrinsic suicide pathways, termed programmed cell death (PCD), are crucial for animal development, tissue homeostasis and pathogenesis. Originally, PCD was virtually synonymous with apoptosis, but recently, alternative PCD mechanisms have been reported. Here, we provide an overview of several distinct PCD mechanisms, namely apoptosis, autophagy and necroptosis. In addition, we discuss the complex signals emanating from dying cells, which can either fuel regeneration or instruct additional killing. Further advances in understanding the physiological role of multiple cell death mechanisms and associated signals will be important to selectively manipulate PCD for therapeutic purposes. PMID:25991373

  16. Multicenter cohort study on the survival time of cancer patients dying at home or in a hospital: Does place matter?

    PubMed

    Hamano, Jun; Yamaguchi, Takashi; Maeda, Isseki; Suga, Akihiko; Hisanaga, Takayuki; Ishihara, Tatsuhiko; Iwashita, Tomoyuki; Kaneishi, Keisuke; Kawagoe, Shohei; Kuriyama, Toshiyuki; Maeda, Takashi; Mori, Ichiro; Nakajima, Nobuhisa; Nishi, Tomohiro; Sakurai, Hiroki; Shimoyama, Satofumi; Shinjo, Takuya; Shirayama, Hiroto; Yamada, Takeshi; Morita, Tatsuya

    2016-05-01

    Although the place of death has a great influence on the quality of death and dying for cancer patients, whether the survival time differs according to the place of death is unclear. The primary aim of this study was to explore potential differences in the survival time of cancer patients dying at home or in a hospital. This multicenter, prospective cohort study was conducted in Japan from September 2012 through April 2014 and involved 58 specialist palliative care services. Among the 2426 patients recruited, 2069 patients were analyzed for this study: 1582 receiving hospital-based palliative care and 487 receiving home-based palliative care. A total of 1607 patients actually died in a hospital, and 462 patients died at home. The survival of patients who died at home was significantly longer than the survival of patients who died in a hospital in the days' prognosis group (estimated median survival time, 13 days [95% confidence interval (CI), 10.3-15.7 days] vs 9 days [95% CI, 8.0-10.0 days]; P = .006) and in the weeks' prognosis group (36 days [95% CI, 29.9-42.1 days] vs 29 days [95% CI, 26.5-31.5 days]; P = .007) as defined by Prognosis in Palliative Care Study predictor model A. No significant difference was identified in the months' prognosis group. Cox proportional hazards analysis revealed that the place of death had a significant influence on the survival time in both unadjusted (hazard ratio [HR], 0.86; 95% CI, 0.78-0.96; P < .01) and adjusted models (HR, 0.87; 95% CI, 0.77-0.97; P = .01). In comparison with cancer patients who died in a hospital, cancer patients who died at home had similar or longer survival. Cancer 2016;122:1453-1460. © 2016 American Cancer Society. © 2015 American Cancer Society.

  17. Years after Inventors Die, Royalties Are Pennies from Heaven

    ERIC Educational Resources Information Center

    Blumenstyk, Goldie

    2009-01-01

    Sarah L. Kieweg had her own nice surprise when the University of Central Florida contacted her. She understood quite a bit about her father's pioneering work on artificial intelligence in the 1990s. Still, in 2006, eight years after he died of a heart attack, at age 50, the call from the university came out of the blue: some of James R. Driscoll's…

  18. Mu opioid receptor availability in people with psychiatric disorders who died by suicide: a case control study

    PubMed Central

    2012-01-01

    Background Mu opioid receptors have previously been shown to be altered in people with affective disorders who died as a result of suicide. We wished to determine whether these changes were more widespread and independent of psychiatric diagnoses. Methods Mu receptor levels were determined using [3 H]DAMGO binding in BA24 from 51 control subjects; 38 people with schizophrenia (12 suicides); 20 people with major depressive disorder (15 suicides); 13 people with bipolar disorder (5 suicides) and 9 people who had no history of psychiatric disorders but who died as a result of suicide. Mu receptor levels were further determined in BA9 and caudate-putamen from 38 people with schizophrenia and 20 control subjects using [3 H]DAMGO binding and, in all three regions, using Western blots. Data was analysed using one-way ANOVAs with Bonferroni’s Multiple Comparison Test or, where data either didn’t approximate to a binomial distribution or the sample size was too small to determine distribution, a Kruskal-Wallis test with Dunn’s Multiple Comparison Test. Results [3 H]DAMGO binding density was lower in people who had died as a result of suicide (p<0.01). People with schizophrenia who had died as a result of suicide had lower binding than control subjects (p<0.001), whilst people with bipolar disorder (non- suicide) had higher levels of binding (p<0.05). [3 H]DAMGO binding densities, but not mu protein levels, were significantly decreased in BA9 from people with schizophrenia who died as a result of suicide (p<0.01). Conclusions Overall these data suggest that mu opioid receptor availability is decreased in the brains of people with schizophrenia who died as a result of suicide, which would be consistent with increased levels of endogenous ligands occupying these receptors. PMID:22925223

  19. 75 FR 11937 - J.I.T. Tool and Die, Inc., Brockport, PA; Notice of Termination of Investigation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-73,086] J.I.T. Tool and Die, Inc., Brockport, PA; Notice of Termination of Investigation Pursuant to Section 223 of the Trade Act of 1974, as... official on behalf of workers of J.I.T. Tool and Die, Inc., Brockport, Pennsylvania. The petitioner has...

  20. Barriers to Quality Care for Dying Patients in Rural Communities

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  1. Identifying palliative care issues in inpatients dying following stroke.

    PubMed

    Ntlholang, O; Walsh, S; Bradley, D; Harbison, J

    2016-08-01

    Stroke leads to high mortality and morbidity but often there is a conflict between need for palliative care and avoidance of 'therapeutic nihilism'. We aimed to elicit the palliative care needs of stroke patients at the end of their lives in our unit with a low overall mortality rate (1 month: 8.8 %, inpatient: 12.9 %). We identified consecutive stroke patients who died over 2 years. Their clinical records were used for data collection. Of 54 deaths, 33 (61.1 %) were females, mean (SD) age at death was 79.3 ± 12.9 years. 41 (75.9 %) died after first stroke, 9 (16.7 %) were inpatient strokes, 7 (13.0 %) thrombolysed and 7 (13.0 %) had strokes as treatment complication. There were clear statements recorded in 26 (48.1 %) that patients were dying and death was thought to be due primarily to extent of brain injury in 24 (44.4 %). Palliative needs identified included dyspnoea 21 (38.9 %), pain 17 (31.5 %), respiratory secretions 17 (31.5 %), agitation 14 (25.9 %) and psychological distress 1 (1.9 %). Symptoms were due to premorbid diseases in 6 (11.1 %). Palliative care expertise were sought in 13 (24.1 %) and continuous subcutaneous infusion was used in 18 (33.3 %) to control symptoms. 4 (7.4 %) subjects underwent cardiac arrest calls and 9 (16.7 %) deaths occurred in ICU/HDU. The median Stroke-Death interval was 20 days (range 0-389). Do Not Attempt Resuscitation (DNAR) orders were in place in 86.8 % of patients. The median DNAR-Death interval was 7 days (range 0-311) with 7-day DNAR-Death rate of 53.2 % and 30-day of 78.7 % of the total deaths. Dyspnoea, pain and respiratory secretions were identified as the main palliative care needs.

  2. The Influence of Temperature on the Frictional Behavior of Duplex-Coated Die Steel Rubbing Against Forging Brass

    NASA Astrophysics Data System (ADS)

    Ebrahimzadeh, I.; Ashrafizadeh, F.

    2015-01-01

    Improvement of die life under hot forging of brass alloys is considered vital from both economical and technical points of view. One of the best methods for improving die life is duplex coatings. In this research, the influence of temperature on the tribological behavior of duplex-coated die steel rubbing against forging brass was investigated. The wear tests were performed on a pin-on-disk machine from room temperature to 700 °C; the pins were made in H13 hot work tool steel treated by plasma nitriding and by PVD coatings of TiN-TiAlN-CrAlN. The disks were machined from a two-phase brass alloy too. The results revealed that the friction coefficient of this tribosystem went through a maximum at 550 °C and decreased largely at 700 °C. Furthermore, the formation of Cr2O3 caused the reduction of friction coefficient at 700 °C. PVD coatings proved their wear resistance up to 550 °C, well above the working temperature of the brass forging dies.

  3. [Dying well seen in the light of self-transcendence and transition : two theories of care helpful to nurses].

    PubMed

    Laporte, Pauline; Vonarx, Nicolas

    2016-06-01

    Accompanying a dying person up to and at the actual moment of death is a duty that often leaves carers at a loss. We shall show how far theoretical nursing knowledge can help practitioners who accompany the end of life by applying two theories of care : Reed’s theory of self-transcendence and Meleis’s theory of transition. Our interpretation of the theory of self-transcendence designates three points of reference in the concept of dying well. The first relates to the overtures prompted by the vulnerability that the context of dying inspires. The second concerns the capacity of the patient to summon up intrapersonal, interpersonal and transpersonal strategies, and the third considers the benefits when self-transcendence is achieved. The theory of transition similarly presents three points of reference. The first is based on informing the patient about palliative care and telling him or her the truth about the prognosis. The second relates to coordinating the interprofessional team that is looking after the dying person. The last criterion is that the palliative care should be started at a suitable moment. This makes it possible to educate a patient who wishes to die at home and thus create an environment favourable to the transition.

  4. To operate or not to operate on women with deep infiltrating endometriosis (DIE) before in vitro fertilization (IVF)

    PubMed Central

    Carneiro, Márcia Mendonça; Costa, Luciana Maria Pyramo; de Ávila, Ivete

    2017-01-01

    Deep infiltrating endometriosis (DIE) can cause infertility and pelvic pain. There is little evidence of a clear connection between DIE and infertility, and the absolute benefits of surgery for DIE have not been established. This paper aimed to review the current literature on the effect of surgery for DIE on fertility, pregnancy, and IVF outcomes. Clinicians should bear in mind that a comprehensive clinical history is useful to identify patients at risk for endometriosis, although many women remain asymptomatic. Imaging can be useful to plan surgery. The effect of surgery on the fertility of women with DIE remains unanswered due to the heterogeneous nature of the disease and the lack of trials with enough statistical power and adequate follow-up. Surgery is not recommended when the main goal is to treat infertility or to improve IVF results. Decisions should be tailored according to the individual needs of each woman. Patients must be provided information on the potential benefits, harm, and costs of each treatment alternative, while the medical team observes factors such as presence of pelvic pain, patient age, lesion location, and previous treatments. In this scenario, management by a multidisciplinary endometriosis team is a key step to achieving successful outcomes. PMID:28609279

  5. Die Digitalisierung der Energiewirtschaft: Potenziale und Herausforderungen der IKT-Branche für Utility 4.0

    NASA Astrophysics Data System (ADS)

    Aichele, Christian; Schönberger, Marius

    Energieunternehmen haben auf dem Weg zur digitalen Transformation noch viele Herausforderungen zu bewältigen. Ein besonderer Schwerpunkt liegt derzeit auf der Modernisierung der IT-Systeme. Ausgangspunkt hierzu ist, dass sich bei den Endkonsumenten Mobile Applikationen, Smartphones, Tablet-PCs oder Smart TVs einer immensen Beliebtheit erfreuen. Durch diese Technologien wird die physische und virtuelle Welt in immer weiter zunehmendem Maße miteinander verknüpft. Mobile Applikation können einen wahren Hype hervorrufen und Verhaltensweisen auch nachhaltig verändern (ein Beispiel hierfür ist Pokémon Go, eine App die ein virtuelles Spiel mit der realen Umgebung kombiniert und die erstmalig auch eingefleischte Zocker aus der Anonymität ihrer häuslichen Umgebung hervorlocken konnte und für analoge Bewegung im Freien sorgte).

  6. Trends and outcomes of cardiac transplantation from donors dying of drug intoxication.

    PubMed

    Warraich, Haider J; Lu, Di; Cobb, Stacy; Cooper, Lauren B; DeVore, Adam; Patel, Chetan B; Rosenberg, Paul B; Schroder, Jacob N; Daneshmand, Mani A; Milano, Carmelo A; Hernandez, Adrian F; Rogers, Joseph G; Mentz, Robert J

    2018-05-01

    Deaths from drug intoxication have increased in the United States but outcomes of recipients of orthotopic heart transplantation (OHT) from these donors are not well characterized. We performed a retrospective analysis of the United Network for Organ Sharing's STAR database between January 2000 and March 2014 and assessed mortality and retransplantation using adjusted Cox models by mechanism of donor death. Of the 31,660 OHTs from 2000 to 2014, 1233 (3.9%) were from drug intoxication. These donors were more likely to be female, white, with greater tobacco use and higher BMI compared to donors who died of other mechanisms. Drug intoxication accounted for 1.1% of OHT donors in 2000 and 6.2% in March 2014. No significant difference was observed in 10-year mortality (adjusted hazard ratio [HR], 95% confidence interval [CI]: 0.99, 0.87-1.13), 10-year retransplantation (adjusted HR 0.84, 0.49-1.41) or 1-year and 3-year rehospitalization with other mechanisms of death compared to drug intoxication. There has been a large increase in OHT donors who die of drug intoxication in the United States. OHT outcomes from these donors are similar to those dying from other mechanisms. These data have important implications for donor selection in context of the ongoing opioid epidemic. Copyright © 2018. Published by Elsevier Inc.

  7. Physiological proteins in resource-limited herbivores experiencing a population die-off

    NASA Astrophysics Data System (ADS)

    Garnier, R.; Bento, A. I.; Hansen, C.; Pilkington, J. G.; Pemberton, J. M.; Graham, A. L.

    2017-08-01

    Nutrient availability is predicted to interact with herbivore population densities. Competition for low quality food at high density may reduce summer food intake, and in turn winter survival. Conversely, low population density may favor physiological recovery through better access to better quality spring forage. Here, we take advantage of the long-term study of the Soay sheep population of St. Kilda (Scotland) to measure plasma protein markers and immunity in two consecutive summers with contrasting population densities. We show that, following a winter die-off resulting in a shift to low population density, albumin and total proteins increased, but only in adult sheep. The effect was not solely attributable to selective disappearance of malnourished sheep. Similarly, the concentration of antibodies was higher following the die-off, potentially indicating recovery of immune function. Overall, our results are consistent with the physiological recovery of surviving individuals after a harsh winter.

  8. Precipitation thresholds and drought-induced tree die-off: insights from patterns of Pinus edulis mortality along an environmental stress gradient.

    PubMed

    Clifford, Michael J; Royer, Patrick D; Cobb, Neil S; Breshears, David D; Ford, Paulette L

    2013-10-01

    Recent regional tree die-off events appear to have been triggered by a combination of drought and heat - referred to as 'global-change-type drought'. To complement experiments focused on resolving mechanisms of drought-induced tree mortality, an evaluation of how patterns of tree die-off relate to highly spatially variable precipitation is needed. Here, we explore precipitation relationships with a die-off event of pinyon pine (Pinus edulis Engelm.) in southwestern North America during the 2002-2003 global-change-type drought. Pinyon die-off and its relationship with precipitation was quantified spatially along a precipitation gradient in north-central New Mexico with standard field plot measurements of die-off combined with canopy cover derived from normalized burn ratio (NBR) from Landsat imagery. Pinyon die-off patterns revealed threshold responses to precipitation (cumulative 2002-2003) and vapor pressure deficit (VPD), with little to no mortality (< 10%) above 600 mm and below warm season VPD of c. 1.7 kPa. [Correction added after online publication 17 June 2013; in the preceding sentence, the word 'below' has been inserted.] Our results refine how precipitation patterns within a region influence pinyon die-off, revealing a precipitation and VPD threshold for tree mortality and its uncertainty band where other factors probably come into play - a response type that influences stand demography and landscape heterogeneity and is of general interest, yet has not been documented. © 2013 No claim to US Government works. New Phytologist © 2013 New Phytologist Trust.

  9. Ni3Al-based alloys for die and tool application

    DOEpatents

    Liu, Chain T.; Bloom, Everett E.

    2001-01-01

    A novel Ni.sub.3 Al-based alloy exhibits strengths and hardness in excess of the standard base alloy IC-221M at temperatures of up to about 1000.degree. C. The alloy is useful in tool and die applications requiring such temperatures, and for structural elements in engineering systems exposed to such temperatures.

  10. The Lived Experiences of Nurses Caring For Dying Pediatric Patients.

    PubMed

    Curcio, Danna L

    2017-01-01

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

  11. Finite Element Analysis of Tube Hydroforming in Non-Symmetrical Dies

    NASA Astrophysics Data System (ADS)

    Nulkar, Abhishek V.; Gu, Randy; Murty, Pilaka

    2011-08-01

    Tube hydroforming has been studied intensively using commercial finite element programs. A great deal of the investigations dealt with models with symmetric cross-sections. It is known that additional constraints due to symmetry may be imposed on the model so that it is properly supported. For a non-symmetric model, these constraints become invalid and the model does not have sufficient support resulting in a singular finite element system. Majority of commercial codes have a limited capability in solving models with insufficient supports. Recently, new algorithms using penalty variable and air-like contact element (ALCE) have been developed to solve positive semi-definite finite element systems such as those in contact mechanics. In this study the ALCE algorithm is first validated by comparing its result against a commercial code using a symmetric model in which a circular tube is formed to polygonal dies with symmetric shapes. Then, the study investigates the accuracy and efficiency of using ALCE in analyzing hydroforming of tubes with various cross-sections in non-symmetrical dies in 2-D finite element settings.

  12. 'If and when?': the beliefs and experiences of community living staff in supporting older people with intellectual disability to know about dying.

    PubMed

    Wiese, M; Dew, A; Stancliffe, R J; Howarth, G; Balandin, S

    2013-10-01

    The aim of this study was to explore the way in which community living staff engaged with people with intellectual disability (ID) about dying and death. Guided by grounded theory methodology, focus groups and individual interviews were conducted with staff who had either no experience with client death, experience of a client sudden death, or a client death experience which was pre-dated by a period of end-of-life care. While in principle, staff unanimously supported the belief that people with ID should know about dying, there was limited in-practice engagement with clients about the topic. Engagement varied according to staff experience, client capacity to understand and the nature of the 'opportunity' to engage. Four 'opportunities' were identified: 'when family die', 'incidental opportunities', 'when clients live with someone who is dying' and 'when a client is dying'. Despite limited engagement by staff, people with ID are regularly exposed to dying and death. People with ID have a fundamental right to know about dying and death. Sophisticated staff skills are required to ensure that people with ID can meaningfully engage with end-of-life issues as opportunities arise. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

  13. Flow rate of some pharmaceutical diluents through die-orifices relevant to mini-tableting.

    PubMed

    Kachrimanis, K; Petrides, M; Malamataris, S

    2005-10-13

    The effects of cylindrical orifice length and diameter on the flow rate of three commonly used pharmaceutical direct compression diluents (lactose, dibasic calcium phosphate dihydrate and pregelatinised starch) were investigated, besides the powder particle characteristics (particle size, aspect ratio, roundness and convexity) and the packing properties (true, bulk and tapped density). Flow rate was determined for three different sieve fractions through a series of miniature tableting dies of different orifice diameter (0.4, 0.3 and 0.2 cm) and thickness (1.5, 1.0 and 0.5 cm). It was found that flow rate decreased with the increase of the orifice length for the small diameter (0.2 cm) but for the large diameter (0.4 cm) was increased with the orifice length (die thickness). Flow rate changes with the orifice length are attributed to the flow regime (transitional arch formation) and possible alterations in the position of the free flowing zone caused by pressure gradients arising from the flow of self-entrained air, both above the entrance in the die orifice and across it. Modelling by the conventional Jones-Pilpel non-linear equation and by two machine learning algorithms (lazy learning, LL, and feed-forward back-propagation, FBP) was applied and predictive performance of the fitted models was compared. It was found that both FBP and LL algorithms have significantly higher predictive performance than the Jones-Pilpel non-linear equation, because they account both dimensions of the cylindrical die opening (diameter and length). The automatic relevance determination for FBP revealed that orifice length is the third most influential variable after the orifice diameter and particle size, followed by the bulk density, the difference between bulk and tapped densities and the particle convexity.

  14. High-Speed Coating Method for Photovoltaic Textiles with Closed-Type Die Coater

    NASA Astrophysics Data System (ADS)

    Imai, Takahiko; Shibayama, Norihisa; Takamatsu, Seiichi; Shiraishi, Kenji; Marumoto, Kazuhiro; Itoh, Toshihiro

    2013-06-01

    We developed a closed-type die-coating method to fabricate thin films for electronic devices. We succeeded in the die-coating of poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS) water dispersions and regioregular poly(3-hexylthiophene):[6,6]-phenyl C61-butyric acid methyl ester (P3HT:PCBM) solution to fabricate thin films of these organic materials with extremely high speeds of 5 and 20 m/min, respectively. The film thicknesses were evaluated by cross-sectional scanning electron microscopy (SEM). The deviations of the film thicknesses from our target values were less than 5%. We fabricated Al/P3HT:PCBM/PEDOT:PSS/indium tin oxide (ITO)/poly(ethylene terephthalate) (PET) textiles as an example of an application of the method, and the photovoltaic characteristic of the devices was confirmed.

  15. Death and Dying--A Living Study. Profiles of Promise 35.

    ERIC Educational Resources Information Center

    Hawke, Sharryl

    Realizing that all students have to deal with death at some time, yet receive no formal education in the subject, Alex Kramer, a high school teacher at Moon High School, Corapolis, Pennsylvania, decided to create a program which would give students an opportunity to study death and the process of dying as integral parts of life. Kramer's goals,…

  16. Report of the Northern California Conference for Guidelines on Aid-in-Dying: definitions, differences, convergences, conclusions.

    PubMed Central

    Young, E W; Marcus, F S; Drought, T; Mendiola, M; Ciesielski-Carlucci, C; Alpers, A; Eaton, M; Koenig, B A; Loewy, E; Raffin, T A; Ross, C

    1997-01-01

    In September 1996, the Stanford University Center for Biomedical Ethics convened a conference entitled "Comprehensive Care of the Terminally Ill: The Northern California Consensus Development Conference for Guidelines on Aid-in-Dying." The regionally based, multidisciplinary conference gathered people from a variety of disciplines and diverse perspectives on physician aid-in-dying. This report documents important points of convergence, disagreement, and uncertainty that emerged from the conference and provides commentary on crucial issues: the definition of terminal illness, ensuring adequate palliative care, psychiatric challenges, coping with family pressures, the doctor-patient relationship, the managed care context, the role of ethics committees, and institutional challenges. Should physician aid-in-dying become a legal practice in California, the report will provide guidance to health care organizations, health professionals, and public policy officials engaged in local or state guideline or policy development. PMID:9217449

  17. Effects of die quench forming on sheet thinning and 3-point bend testing of AA7075-T6

    NASA Astrophysics Data System (ADS)

    Kim, Samuel; Omer, Kaab; Rahmaan, Taamjeed; Butcher, Clifford; Worswick, Michael

    2017-10-01

    Lab-scaled AA7075 aluminum side impact beams were manufactured using the die quenching technique in which the sheet was solutionized and then quenched in-die during forming to a super saturated solid state. Sheet thinning measurements were taken at various locations throughout the length of the part and the effect of lubricant on surface scoring and material pick-up on the die was evaluated. The as-formed beams were subjected to a T6 aging treatment and then tested in three-point bending. Simulations were performed of the forming and mechanical testing experiments using the LS-DYNA finite element code. The thinning and mechanical response was predicted well.

  18. What do prostate cancer patients die of?

    PubMed

    Riihimäki, Matias; Thomsen, Hauke; Brandt, Andreas; Sundquist, Jan; Hemminki, Kari

    2011-01-01

    A recent rise in the incidence of prostate cancer and a more favorable outcome have increased the proportions of other causes of death in affected men. Extending the survival of prostate cancer patients thus requires knowledge of all causes of death. Data on the population, cancers, and causes of death were gathered from the nationwide Swedish Family-Cancer Database. A Cox regression model, comparing prostate cancer patients with all other men, was applied. Hazard ratios (HR) were calculated both for the underlying cause and for dying with a specific cause listed among multiple causes of death. Among 686,500 observed deaths, 62,500 were prostate cancer patients. For underlying causes other than prostate cancer, the highest cause-specific HRs were found for external causes (HR, 1.24; 95% confidence interval [CI], 1.16-1.31), diseases of the pulmonary circulation (HR, 1.22; 95% CI, 1.09-1.37), and heart failure (HR, 1.18; 95% CI, 1.11-1.24). For specific multiple causes, the highest HRs were found for anemia (HR, 2.28; 95% CI, 2.14-2.42), diseases of the pulmonary circulation (HR, 1.61; 95% CI, 1.55-1.68), and urinary system disease (HR, 1.90; 95% CI, 1.84-1.96). Prostate cancer patients have a higher risk for dying from various causes other than prostate cancer, including external causes and heart failure. Mechanisms have been proposed linking these elevated risks to both cancer and treatment. More attention should be paid to comorbidities in men with prostate cancer. The present study fulfills a gap in the knowledge of death causes in prostate cancer patients.

  19. Investigations of a large scale eared grebe (Podiceps nigricollis) die-off at the Salton Sea, California in 1992

    USGS Publications Warehouse

    Meteyer, C.U.; Audet, D.J.; Rocke, T.E.; Radke, W.; Creekmore, L.H.; Duncan, R.

    2004-01-01

    An estimated 150,000 Eared Grebes (Podiceps nigricollis) died at the Salton Sea between 16 December 1991 and 21 April 1992. This represented the largest documented mortality event of Eared Grebes at the time and approximately 6% of the North American population. During the die-off, grebes exhibited several uncharacteristic behaviors, such as congregating at freshwater tributaries, repeatedly gulping freshwater, preening excessively, moving onto land, and allowing close approach and/or capture. Avian cholera was diagnosed in Eared Grebes collected along the north and west shoreline of the Sea late in the die-off but not from the majority of the Eared Grebes dying along the south shore. Gross and histological examinations and diagnostic testing for viruses, bacteria, and parasites did not identify the cause of mortality in the majority of Eared Grebes examined from the south shore of the Sea. Liver concentrations of arsenic, chromium, DDE, mercury, selenium, and zinc were elevated in some Eared Grebes, but none of those contaminants exceeded known thresholds for independent lethality. Poisoning by heavy metals, organochlorine, organophosphorus, or carbamate pesticides, avian botulism, and salt were ruled out as the cause of mortality. Hypotheses for the die-off are interactive effects of contaminants, immunosuppression, a yet unidentified biotoxin or pathogen present in the Salton Sea, impairment of feather waterproofing leading to hypothermia, or a unique manifestation of avian cholera that evades laboratory detection.

  20. Unequal care for dying patients in Sweden: a comparative registry study of deaths from heart disease and cancer.

    PubMed

    Brännström, Margareta; Hägglund, Lena; Fürst, Carl Johan; Boman, Kurt

    2012-12-01

    The Swedish Palliative Registry is a nationwide quality registry aimed at facilitating improvement in end-of-life care. The goal is for the registry to list and report quality indicators related to care during the last week of life in all cases expected death in Sweden. To examine the quality of care during the last week of life as reported to the registry for patients with heart disease compared to those with cancer. A retrospective registry study. Patients dying of heart disease compared to those dying from cancer had more shortness of breath, fewer drugs prescribed as needed against the usual symptoms and often died alone. Furthermore, they and their close relatives received less information about the imminence of death and bereavement follow-up was less common. The healthcare personnel were less aware of the heart disease patients' symptoms and less often knew about where they wished to die. Great differences were found in registered end-of-life care suggesting that the care given to patients with heart disease and cancer was unequal even after adjustment for age, sex and setting at the time of death. If our observational findings are confirmed in future studies there is obviously a need for new models for end-of-life management in order to facilitate the provision of equal care to dying patients regardless of diagnosis.

  1. Production of High Quality Die Steels from Large ESR Slab Ingots

    NASA Astrophysics Data System (ADS)

    Geng, Xin; Jiang, Zhou-hua; Li, Hua-bing; Liu, Fu-bin; Li, Xing

    With the rapid development of manufacture industry in China, die steels are in great need of large slab ingot of high quality and large tonnage, such as P20, WSM718R and so on. Solidification structure and size of large slab ingots produced with conventional methods are not satisfied. However, large slab ingots manufactured by ESR process have a good solidification structure and enough section size. In the present research, the new slab ESR process was used to produce the die steels large slab ingots with the maximum size of 980×2000×3200mm. The compact and sound ingot can be manufactured by the slab ESR process. The ultra-heavy plates with the maximum thickness of 410 mm can be obtained after rolling the 49 tons ingots. Due to reducing the cogging and forging process, the ESR for large slab ingots process can increase greatly the yield and production efficiency, and evidently cut off product costs.

  2. Knowing Kids Dying of HIV: A Traumatic Event for AIDS Orphans

    PubMed Central

    Zhao, Qun; Li, Xiaoming; Lin, Xiuyun; Fang, Xiaoyi; Zhao, Guoxiang; Zhao, Junfeng

    2009-01-01

    Data from 755 AIDS orphans living in a rural area of China with high rates of HIV infection were used to examine the association between a child’s trauma symptoms and knowing a peer with HIV infection or one who had died of HIV. Trauma symptoms were measured by the Traumatic Symptoms Checklist for Children-Chinese Version (TSCC-CV). About 47% of participants reported they knew a child with HIV or one who had died of HIV. More orphans living in family-based care reported such knowledge, and trauma symptoms were significantly higher in children who reported such knowledge. Multivariate analysis revealed that such knowledge was significantly associated with traumatic symptoms, controlling for gender, age, family socioeconomic status, orphan status (double vs. single), and care arrangement (family-based vs. institutional care). The findings underscored the importance of psychosocial support and counseling to orphans in communities with high levels of HIV-related mortality. PMID:19576544

  3. [Right to die with dignity?].

    PubMed

    Ruiz, Alvaro

    2008-06-01

    The right to die with dignity is an ill-defined concept, with multiple, often inappropriate, interpretations. The current proposition is that the physician take full responsibility for protecting the patients rights, for ensuring a rational use of resources and for overseeing the decision-making process such that the information is adequate and the steps proportioned. This responsibility extends not only to the health status of the patient situation, to the patients prognosis, and to his/her expectations and wishes, but also to the benefits foreseen and to the cost-benefit ratio. Emphasis is placed on two aspects of this relationship. First, dignity can be interpreted in many ways and sometimes, in the name of dignity, the patient is exposed (or exposes him/herself) to suffering, pain and complications that can be avoided. Second, when no reasonable probability of survival is present and a better quality of life is impossible, efforts are better redirected to offering a better quality of death.

  4. Characteristics of Chinese rural young suicides: who did not have a strong intent to die.

    PubMed

    Sun, Long; Zhang, Jie

    2015-02-01

    In exploration of the risk factors of the Chinese rural young suicide, previous researchers found low prevalence of mental problems, high degree of impulsivity, and great proportion of lethal pesticide consumption. It noticed that some of the young suicides in rural China did not intend to die from the suicidal behavior which was only instrumentally used for certain gains. This study aims to look into the characteristics of those young suicides who did not really intend to die and compare them with those young suicides who had a strong intent to die. Subjects were 386 suicides aged 15-34years in the rural areas of three provinces in China. The data were obtained by psychological autopsy method. The degree of suicidal intent of the subjects was evaluated by the first 8 items of Beck's Suicide Intent Scale (SIS). It was found that those suicides that had a strong intent of death were more likely to have higher age, more years of education, live alone, and suffer mental disease. On the other hand, the low intent suicides were more likely to have pesticides at home and to be impulsive. In other words, pesticides and impulsivity killed some Chinese rural young men and women who did not really want to die by suicide. Findings of the study may be translated into practical measures in suicide prevention in China as well as elsewhere in the world. Copyright © 2014 Elsevier Inc. All rights reserved.

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

    PubMed

    Fridh, Isabell; Forsberg, Anna; Bergbom, Ingegerd

    2009-10-01

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

  6. Summer's End and Sad Goodbyes: Children's Picturebooks about Death and Dying

    ERIC Educational Resources Information Center

    Wiseman, Angela M.

    2013-01-01

    This article explores children's picturebooks about death and grieving by considering both psychological and literary aspects. Two questions frame this analysis: How can picturebooks, particularly written for young children, support children's grief when someone dies? How do the illustrations and text of picture books express and convey the…

  7. Children's Rights, "die Antipadagogen," and the Paternalism of John Stuart Mill.

    ERIC Educational Resources Information Center

    Nordenbo, Sven Erik

    1987-01-01

    Mill's liberty principle and the children's rights movement ("die Antipadagogen") are discussed in terms of Mill's attitude of paternalism in children's education. Mill contends that the individual liberty of children must be limited for their own good. Proponents of educational liberalism are not justified in claiming Mill as a…

  8. In-die photomask registration and overlay metrology with PROVE using 2D correlation methods

    NASA Astrophysics Data System (ADS)

    Seidel, D.; Arnz, M.; Beyer, D.

    2011-11-01

    According to the ITRS roadmap, semiconductor industry drives the 193nm lithography to its limits, using techniques like double exposure, double patterning, mask-source optimization and inverse lithography. For photomask metrology this translates to full in-die measurement capability for registration and critical dimension together with challenging specifications for repeatability and accuracy. Especially, overlay becomes more and more critical and must be ensured on every die. For this, Carl Zeiss SMS has developed the next generation photomask registration and overlay metrology tool PROVE® which serves the 32nm node and below and which is already well established in the market. PROVE® features highly stable hardware components for the stage and environmental control. To ensure in-die measurement capability, sophisticated image analysis methods based on 2D correlations have been developed. In this paper we demonstrate the in-die capability of PROVE® and present corresponding measurement results for shortterm and long-term measurements as well as the attainable accuracy for feature sizes down to 85nm using different illumination modes and mask types. Standard measurement methods based on threshold criteria are compared with the new 2D correlation methods to demonstrate the performance gain of the latter. In addition, mask-to-mask overlay results of typical box-in-frame structures down to 200nm feature size are presented. It is shown, that from overlay measurements a reproducibility budget can be derived that takes into account stage, image analysis and global effects like mask loading and environmental control. The parts of the budget are quantified from measurement results to identify critical error contributions and to focus on the corresponding improvement strategies.

  9. Robot-based additive manufacturing for flexible die-modelling in incremental sheet forming

    NASA Astrophysics Data System (ADS)

    Rieger, Michael; Störkle, Denis Daniel; Thyssen, Lars; Kuhlenkötter, Bernd

    2017-10-01

    The paper describes the application concept of additive manufactured dies to support the robot-based incremental sheet metal forming process (`Roboforming') for the production of sheet metal components in small batch sizes. Compared to the dieless kinematic-based generation of a shape by means of two cooperating industrial robots, the supporting robot models a die on the back of the metal sheet by using the robot-based fused layer manufacturing process (FLM). This tool chain is software-defined and preserves the high geometrical form flexibility of Roboforming while flexibly generating support structures adapted to the final part's geometry. Test series serve to confirm the feasibility of the concept by investigating the process challenges of the adhesion to the sheet surface and the general stability as well as the influence on the geometric accuracy compared to the well-known forming strategies.

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

    PubMed

    Loewy, Erich H

    1988-01-01

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

  11. Management of Lesion Nematodes and Potato Early Dying with Rotation Crops

    PubMed Central

    LaMondia, J.A.

    2006-01-01

    Soil-incorporated rotation/green manure crops were evaluated for management of potato early dying caused by Verticillium dahliae and Pratylenchus penetrans. After two years of rotation/green manure and a subsequent potato crop, P. penetrans numbers were less after ‘Saia’ oat/‘Polynema’ marigold, ‘Triple S’ sorghum-sudangrass, or ‘Garry’ oat than ‘Superior’ potato or ‘Humus’ rapeseed. The area under the disease progress curve (AUDPC) for early dying was lowest after Saia oat/marigold, and tuber yields were greater than continuous potato after all crops except sorghum-sudangrass. Saia oat/marigold crops resulted in the greatest tuber yields. After one year of rotation/green manure, a marigold crop increased tuber yields and reduced AUDPC and P. penetrans. In the second potato crop after a single year of rotation, plots previously planted to marigolds had reduced P. penetrans densities and AUDPC and increased tuber yield. Rapeseed supported more P. penetrans than potato, but had greater yields. After two years of rotation/green manure crops and a subsequent potato crop, continuous potato had the highest AUDPC and lowest tuber weight. Rotation with Saia oats (2 yr) and Rudbeckia hirta (1 yr) reduced P. penetrans and increased tuber yields. AUDPC was lowest after R. hirta. Two years of sorghum-sudangrass did not affect P. penetrans, tuber yield or AUDPC. These results demonstrate that P. penetrans may be reduced by one or two years of rotation to non-host or antagonistic plants such as Saia oat, Polynema marigold, or R. hirta and that nematode control may reduce the severity of potato early dying. PMID:19259461

  12. Where a Cancer Patient Dies: The Effect of Rural Residency

    ERIC Educational Resources Information Center

    Burge, Frederick I.; Lawson, Beverley; Johnston, Grace

    2005-01-01

    Context: Surveys indicate 50% to 80% of cancer patients would choose to die at home if possible, although far fewer actually do. In Nova Scotia (NS), cancer deaths occurring out-of-hospital increased from 19.8% in 1992 to 30.2% in 1997. The impact of rural residency on this trend has not been studied. Purpose: To determine the association between…

  13. Motivations, Satisfaction, and Fears of Death and Dying in Residential Hospice Volunteers: A Prospective Longitudinal Study.

    PubMed

    Nissim, Rinat; Emmerson, Debbie; O'Neill, Bill; Marchington, Katie; Draper, Haley; Rodin, Gary

    2016-05-01

    Studies conducted on hospice volunteers' characteristics and experiences have been cross-sectional. We conducted a prospective study to examine changes in the volunteer experience over time in a cohort of volunteers during the first year of a new residential hospice. Eighty-two active volunteers completed an online baseline survey, and of these, 39 completed a follow-up survey at 6 months. The survey included measures of motivations to volunteer, satisfaction with role and with the organization, and fear of death and dying. Repeated measures analyses indicated that motivations to volunteer remained stable over time while volunteer satisfaction increased with time. Baseline level of fears of death and dying varied by age, volunteer role, and motivations to volunteer and decreased at 6 months. Volunteering in a residential hospice tends to be a satisfying experience that helps to allay fears about death and dying. © The Author(s) 2014.

  14. Shifting hospital-hospice boundaries: historical perspectives on the institutional care of the dying.

    PubMed

    Risse, Guenter B; Balboni, Michael J

    2013-06-01

    Social forces have continually framed how hospitals perceive their role in care of the dying. Hospitals were originally conceived as places of hospitality and spiritual care, but by the 18th century illness was an opponent, conquered through science. Medicalization transformed hospitals to places of physical cure and scientific prowess. Death was an institutional liability. Equipped with new technologies, increased public demand, and the establishment of Medicare in 1965, modern hospitals became the most likely place for Americans to die--increasing after the 1940s and spiking in the 1990s. Medicare's 1983 hospice benefit began to reverse this trend. Palliative care has more recently proliferated, suggesting an institutional shift of alignment with traditional functions of care toward those facing death.

  15. The Effect of Alloying Elements on Thermal Conductivity and Casting Characteristic in High Pressure Die Casting of Aluminum Alloy

    NASA Astrophysics Data System (ADS)

    Kim, Cheol-Woo; Cho, Jae-Ik; Choi, Se-Weon; Kim, Young-Chan; Kang, Chang-Seog

    Recently, demand of aluminum alloys for use in high thermal conductivity application is increases but the most aluminum die casting alloys exhibit very lower thermal properties because of their high concentrations of alloying elements. However, those alloying elements are essential to obtain sufficient fluidity and mechanical strength. Therefore, the purpose of this study is to analyze the effect of alloying elements in die casting alloys, Si, Cu, Mg, Fe and Mn, in thermal conductivity, die casting characteristics and mechanical properties and find out the appropriate amount of each alloying element for development of heat sink component. The results showed that Mn had the most deleterious effect in thermal conductivity and Si and Fe contents were important to improve strength and limit casting defects, such as hot tearing and die soldering. The alloy with 0.2 1.0wt%Cu, 0.3 0.6wt%Fe and 1.0 2.0wt%Si showed very good combination of high thermal conductivity and good casting characteristics.

  16. The experiences of staff who support people with intellectual disability on issues about death, dying and bereavement: A metasynthesis.

    PubMed

    Lord, Ailsa J; Field, Stephen; Smith, Ian C

    2017-11-01

    Historically, people with intellectual disabilities have tended to be excluded from knowing about death, dying and bereavement. Staff in intellectual disability services can play a valuable role in improving understanding of these issues in those they support. This qualitative metasynthesis aimed to understand the experiences of staff supporting adults with intellectual disabilities with issues of death, dying and bereavement. Thirteen papers were identified following a systematic review of six databases. Three themes were developed following a lines-of-argument synthesis: (i) talking about death is hard: negotiating the uncertainty in death, dying and bereavement; (ii) the commitment to promoting a "good death"; and (iii) the grief behind the professional mask. "A cautious silence: The taboo of death" was an overarching theme. A more open culture around issues of death, dying and bereavement in intellectual disability settings is essential and could be promoted through staff training and support. © 2017 John Wiley & Sons Ltd.

  17. Sentenced to Die: Capital Punishment and the Eighth Amendment. Teacher's Guide.

    ERIC Educational Resources Information Center

    Madden, Mary

    This teacher's guide is designed to accompany the three-part videotape "Sentenced to Die." The videotape and teacher's guide should help students to: (1) understand the history of the Eighth Amendment; (2) examine the controversy surrounding the death penalty; (3) compare and contrast differing viewpoints on capital punishment; and (4)…

  18. Thermal fatigue behavior of H-13 die steel for aluminum die casting with various ion sputtered coatings

    NASA Technical Reports Server (NTRS)

    Nieh, C. Y.; Wallace, J. F.

    1981-01-01

    Sputtered coatings of Mo, W, Pt, Ag, Au, Co, Cr, Ni, Ag + Cu, Mo + Pt, Si3N4, A1N, Cr3C2, Ta5Si3, and ZrO2 were applied to a 2-inch-square, 7-inch-long thermal fatigue test specimen which was then internally water cooled and alternately immersed in molten aluminum and cooled in air. After 15,000 cycles the thermal fatigue cracks at the specimen corners were measured. Results indicate that a significant improvement in thermal fatigue resistance was obtained with platinum, molybdenum, and tungsten coatings. Metallographic examination indicates that the improvement in thermal fatigue resistance resulted from protection of the surface of the die steel from oxidation. The high yield strength and ductility of molybdenum and tungsten contributed to the better thermal fatigue resistance.

  19. Bemerkungen ueber die "Einheitlichen Pruefungsanforderungen in der Abiturpruefung: Englisch" (Remarks on the "Uniform Examination Requirements" for the Graduation Examination in English)

    ERIC Educational Resources Information Center

    Ahrens, Ruediger; Huellen, Werner

    1977-01-01

    The "Uniform Graduation Examination Requirements" for English are examined and, in general, approved. But the written portion needs better description; the "Translation" and "Summary and Text Discussion" portions should be changed. Distinctions between basic and honors courses are unclear. Description and rating of…

  20. End-of-Life Care and Quality of Dying in 23 Acute Geriatric Hospital Wards in Flanders, Belgium.

    PubMed

    Verhofstede, Rebecca; Smets, Tinne; Cohen, Joachim; Eecloo, Kim; Costantini, Massimo; Van Den Noortgate, Nele; Deliens, Luc

    2017-04-01

    To describe the nursing and medical interventions performed in the last 48 hours of life and the quality of dying of patients dying in acute geriatric hospital wards. Cross-sectional descriptive study between October 1, 2012 and September 30, 2013. Twenty-three acute geriatric wards in 13 hospitals in Flanders, Belgium. Patients hospitalized for more than 48 hours before dying in the participating wards. Structured after-death questionnaires, filled out by the nurse, the physician, and the family carer most involved in end-of-life care. Main outcome measures were several nursing and medical interventions reported to be performed in the last 48 hours of life and the quality of dying. Of 993 patients, we included 338 (mean age 85.7 years; 173 women). Almost 58% had dementia and nearly half were unable to communicate in the last 48 hours of their life. The most frequently continued or started nursing and medical interventions in the last 48 hours of life were measuring temperature (91.6%), repositioning (83.3%), washing (89.5%), oxygen therapy (49.7%), and intravenous fluids and nutrition (30%). Shortness of breath, lack of serenity, lack of peace, and lack of calm were symptoms reported most frequently by nurses and family carers. Many nursing and medical interventions are continued or started in the last hours of a patient's life, which may not always be in their best interests. Furthermore, patients dying in acute geriatric wards are often affected by several symptoms. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.