Science.gov

Sample records for study period die

  1. Exploratory study on H13 steel dies

    SciTech Connect

    Sunwoo, A.J.

    1994-04-01

    Ultrahigh-strength H13 steel is a recommended die material for aluminum die casting; dies made from H13 steel can be safely water- cooled during hot working operations without cracking. However, after time the dies exhibited surface cracking and excessive wear. Erosive wear also occurs owing to high pressure injection of molten Al. An exploratory study was made of the causes for surface cracking of H13 dies. Results suggest that surface cracking is caused by interrelated factors, internal to the die material as well as externally induced conditions.

  2. 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...

  3. 26 CFR 20.2201-1 - Members of the Armed Forces dying during an induction period.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 14 2011-04-01 2010-04-01 true 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...

  4. 26 CFR 20.2201-1 - Members of the Armed Forces dying during an induction period.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 14 2012-04-01 2012-04-01 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...

  5. 26 CFR 20.2201-1 - Members of the Armed Forces dying during an induction period.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 14 2013-04-01 2013-04-01 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...

  6. 26 CFR 20.2201-1 - Members of the Armed Forces dying during an induction period.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 14 2014-04-01 2013-04-01 true 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...

  7. 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…

  8. 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…

  9. Determinants of the risk of dying of HIV/AIDS in a rural South African community over the period of the decentralised roll-out of antiretroviral therapy: a longitudinal study

    PubMed Central

    Mee, Paul; Collinson, Mark A.; Madhavan, Sangeetha; Kabudula, Chodziwadziwa; Gómez-Olivé, Francesc Xavier; Kahn, Kathleen; Tollman, Stephen M.; Hargreaves, James; Byass, Peter

    2014-01-01

    Background Antiretroviral treatment (ART) has significantly reduced HIV mortality in South Africa. The benefits have not been experienced by all groups. Here we investigate the factors associated with these inequities. Design This study was located in a rural South African setting and used data collected from 2007 to 2010, the period when decentralised ART became available. Approximately one-third of the population were of Mozambican origin. There was a pattern of repeated circular migration between urban areas and this community. Survival analysis models were developed to identify demographic, socioeconomic, and spatial risk factors for HIV mortality. Results Among the study population of 105,149 individuals, there were 2,890 deaths. The HIV/TB mortality rate decreased by 27% between 2007–2008 and 2009–2010. For other causes of death, the reduction was 10%. Bivariate analysis found that the HIV/TB mortality risk was lower for: those living within 5 km of the Bhubezi Community Health Centre; women; young adults; in-migrants with a longer period of residence; permanent residents; and members of households owning motorised transport, holding higher socioeconomic positions, and with higher levels of education. Multivariate modelling showed, in addition, that those with South Africa as their country of origin had an increased risk of HIV/TB mortality compared to those with Mozambican origins. For males, those of South African origin, and recent in-migrants, the risk of death associated with HIV/TB was significantly greater than that due to other causes. Conclusions In this community, a combination of factors was associated with an increased risk of dying of HIV/TB over the period of the roll-out of ART. There is evidence for the presence of barriers to successful treatment for particular sub-groups in the population, which must be addressed if the recent improvements in population-level mortality are to be maintained. PMID:25416322

  10. Do imaginary companions die? An exploratory study.

    PubMed

    Kastenbaum, Robert; Fox, Lynn

    Adults in this exploratory study usually recalled that their childhood imaginary companions faded away or were dismissed as other options for social interaction became more appealing. However, eight participants reported that their IC had died. Analysis of these deaths offers a glimpse of the child's talent for transitional thought processes that navigate between the emerging constraints of logic and the continuing appeal of fantasy. It is suggested that young children are testing the limits and possibilities of what it means to be "real" at the same time they are trying to puzzle out "alive" and "dead."

  11. Fewer Patients Die During Hospital Inspection Weeks: Study

    MedlinePlus

    ... 164254.html Fewer Patients Die During Hospital Inspection Weeks: Study Slight differences in death rates were possibly ... likely to die if they are treated during weeks that inspectors are checking on the staff, a ...

  12. 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.

  13. 8 CFR 319.3 - Surviving spouses of United States citizens who died during a period of honorable service in an...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... who died during a period of honorable service in an active duty status in the Armed Forces of the... Surviving spouses of United States citizens who died during a period of honorable service in an active duty... her citizen spouse died during a period of honorable service in an active duty status in the Armed...

  14. 8 CFR 319.3 - Surviving spouses of United States citizens who died during a period of honorable service in an...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... who died during a period of honorable service in an active duty status in the Armed Forces of the... Surviving spouses of United States citizens who died during a period of honorable service in an active duty...) Establish that his or her citizen spouse, child, or parent died during a period of honorable service in an...

  15. 8 CFR 319.3 - Surviving spouses of United States citizens who died during a period of honorable service in an...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... who died during a period of honorable service in an active duty status in the Armed Forces of the... Surviving spouses of United States citizens who died during a period of honorable service in an active duty...) Establish that his or her citizen spouse, child, or parent died during a period of honorable service in an...

  16. Nursing home residents dying with dementia in Flanders, Belgium: a nationwide postmortem study on clinical characteristics and quality of dying.

    PubMed

    Vandervoort, An; Van den Block, Lieve; van der Steen, Jenny T; Volicer, Ladislav; Vander Stichele, Robert; Houttekier, Dirk; Deliens, Luc

    2013-07-01

    There is a lack of large-scale, nationwide data describing clinical characteristics and quality of dying of nursing home residents dying with dementia. We set out to investigate quality of end-of-life care and quality of dying of nursing home residents with dementia in Flanders, Belgium. To obtain representativity, we conducted a postmortem study (2010) using random cluster sampling. In selected nursing homes, all deceased residents with dementia in a period of 3 months were reported. For each case, a structured questionnaire was filled in by the nurse most involved in care, the family physician, and the nursing home administrator. We used the Cognitive Performance Scale and Global Deterioration Scale to assess dementia. Main outcome measures were health status, clinical complications, symptoms at the end of life, and quality of dying. Health status, clinical complications, symptoms at the end of life, and quality of dying. We identified 198 deceased residents with dementia in 69 nursing homes (58% response rate). Age distribution was the same as all deceased residents with dementia in Flanders, 2010. Fifty-four percent had advanced dementia. In the last month of life, 95.5% had 1 or more sentinel events (eg, eating/drinking problems, febrile episodes, or pneumonia); most frequently reported symptoms were pain, fear, anxiety, agitation, and resistance to care. In the last week, difficulty swallowing and pain were reported most frequently. Pressure sores were present in 26.9%, incontinence in 89.2%, and cachexia in 45.8%. Physical restraints were used in 21.4% of cases, and 10.0% died outside the home. Comparing stages of dementia revealed few differences between groups regarding clinical complications, symptoms, or quality of dying. Regardless of the dementia stage, many nursing home residents develop serious clinical complications and symptoms in the last phase of life, posing major challenges to the provision of optimum end-of-life care. Copyright © 2013

  17. 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

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

    PubMed

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

    2013-03-13

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

  19. Study of sintered silver as a die attach material

    NASA Astrophysics Data System (ADS)

    Sood, Falguni Vikram

    Sintered silver has become a viable and attractive alternative to soldering in various applications especially for high power and high temperature needs. The sintering process used till now is mostly pressure assisted which requires specialized equipment in the processing. A pressure-less sintering process which can be incorporated with the existing equipment is highly desired. The primary objective of this study was to analyze how the sintered silver bond formed behaves with different process and material parameters while using pressure-less sintering. Commercially available dual sized sintered silver paste consisting of micron and sub-micron particles has been studied. The sintering parameters: die/substrate metallization (Au/Ag), sintering temperature and sintering atmosphere were varied. Also an aging study at 220°C was done. It was found that the substrate and die metallization and type affected the characteristics of the sintered bond and the die shear strength. Sintering at 250°C in air atmosphere caused a gap layer to form along with the dense silver layer near the gold surfaces. This gap layer resulted in very low die shear strength thus affecting the reliability while nitrogen atmosphere at 250°C produced a different microstructure without a gap formation. With increase in sintering temperature the die shear strength increases for Ag surface die & substrate while it decreases for Au surfaces. Aging at 220°C produced the densified cluster formation that also involved the shrinkage, thereby resulting in an increase in void spacing between those clusters.

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

    PubMed

    King, Phyllis Ann; Thomas, Sandra P

    2013-11-01

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

  1. 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

  2. Dying at home in Belgium: a descriptive GP interview study

    PubMed Central

    2012-01-01

    Background While increasing attention is being paid to enabling terminal patients to remain at home until death, limited information is available on the circumstances in which people at home actually die. Therefore this study aims to describe patient characteristics, functional and cognitive status and physical and psychological symptom burden in the last three months of life among Belgian patients dying at home, according to their GPs. Methods In 2005, a nationwide and retrospective interview study with GPs took place on people dying at home in Belgium as reported by Sentinel Network of GPs in Belgium. GPs registered all deaths (patients aged 1 year or more) weekly and were interviewed about all patients dying non-suddenly at home, using face-to-face structured interviews. Results Interviews were obtained on 205 patients (90% response rate). Between the second and third month before death, 55% were fully invalid or limited in self-care. In the last week of life, almost all were fully invalid. Fifty four percent were unconscious at some point during the last week; 46% were fully conscious. Most frequently reported symptoms were lack of energy, lack of appetite and feeling drowsy. Conditions most difficult for GPs to manage were shortness of breath, lack of energy and pain. Conclusions Many people dying at home under the care of their GPs in Belgium function relatively well until the last week of life and cognitive status seems to be preserved until the end in many cases. However, symptoms which GPs find difficult to control still manifest in many patients in the final week of life. PMID:22260260

  3. Dying at home in Belgium: a descriptive GP interview study.

    PubMed

    Leemans, Kathleen; Van den Block, Lieve; Bilsen, Johan; Cohen, Joachim; Boffin, Nicole; Deliens, Luc

    2012-01-19

    While increasing attention is being paid to enabling terminal patients to remain at home until death, limited information is available on the circumstances in which people at home actually die. Therefore this study aims to describe patient characteristics, functional and cognitive status and physical and psychological symptom burden in the last three months of life among Belgian patients dying at home, according to their GPs. In 2005, a nationwide and retrospective interview study with GPs took place on people dying at home in Belgium as reported by Sentinel Network of GPs in Belgium. GPs registered all deaths (patients aged 1 year or more) weekly and were interviewed about all patients dying non-suddenly at home, using face-to-face structured interviews. Interviews were obtained on 205 patients (90% response rate). Between the second and third month before death, 55% were fully invalid or limited in self-care. In the last week of life, almost all were fully invalid. Fifty four percent were unconscious at some point during the last week; 46% were fully conscious. Most frequently reported symptoms were lack of energy, lack of appetite and feeling drowsy. Conditions most difficult for GPs to manage were shortness of breath, lack of energy and pain. Many people dying at home under the care of their GPs in Belgium function relatively well until the last week of life and cognitive status seems to be preserved until the end in many cases. However, symptoms which GPs find difficult to control still manifest in many patients in the final week of life.

  4. 29 CFR 4022.103 - Who will get benefits if I die when payments for future periods under a certain-and-continuous or...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Who will get benefits if I die when payments for future... Payments Owed for Future Periods After Death § 4022.103 Who will get benefits if I die when payments for future periods under a certain-and-continuous or similar annuity are owed upon my death? If you die at a...

  5. 29 CFR 4022.103 - Who will get benefits if I die when payments for future periods under a certain-and-continuous or...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Who will get benefits if I die when payments for future... Payments Owed for Future Periods After Death § 4022.103 Who will get benefits if I die when payments for future periods under a certain-and-continuous or similar annuity are owed upon my death? If you die at a...

  6. 29 CFR 4022.103 - Who will get benefits if I die when payments for future periods under a certain-and-continuous or...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Who will get benefits if I die when payments for future... Payments Owed for Future Periods After Death § 4022.103 Who will get benefits if I die when payments for future periods under a certain-and-continuous or similar annuity are owed upon my death? If you die at a...

  7. 29 CFR 4022.103 - Who will get benefits if I die when payments for future periods under a certain-and-continuous or...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Who will get benefits if I die when payments for future... Payments Owed for Future Periods After Death § 4022.103 Who will get benefits if I die when payments for future periods under a certain-and-continuous or similar annuity are owed upon my death? If you die at a...

  8. 29 CFR 4022.103 - Who will get benefits if I die when payments for future periods under a certain-and-continuous or...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Who will get benefits if I die when payments for future... Payments Owed for Future Periods After Death § 4022.103 Who will get benefits if I die when payments for future periods under a certain-and-continuous or similar annuity are owed upon my death? If you die at a...

  9. 8 CFR 319.3 - Surviving spouses of United States citizens who died during a period of honorable service in an...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... who died during a period of honorable service in an active duty status in the Armed Forces of the... status in the Armed Forces of the United States. (a) Eligibility. To be eligible for naturalization under... her citizen spouse died during a period of honorable service in an active duty status in the...

  10. A multicenter retrospective cohort study of 'talk and die' after traumatic brain injury.

    PubMed

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

    2017-07-29

    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 endpoint was in-hospital mortality. We compared patients who talked and died to the 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.

  11. Older people dying with dementia: a nationwide study.

    PubMed

    Meeussen, Koen; Van den Block, Lieve; Echteld, Michael; Boffin, Nicole; Bilsen, Johan; Van Casteren, Viviane; Deliens, Luc

    2012-10-01

    Large-scale nationwide data describing the end-of-life characteristics of older people with dementia are lacking. This paper describes the dying process and end-of-life care provided to elderly people with mild or severe dementia in Belgium. It compares with elderly people dying without dementia. A nationwide retrospective mortality study was conducted, via representative network of general practitioners (GPs) in 2008 in Belgium, with weekly registration of all deaths (aged ≥ 65) using a standardized form. GPs reported on diagnosis and severity of dementia, aspects of end-of-life care and communication, and on the last week of life in terms of symptoms that caused distress as judged by the GP, and the patients' physical and cognitive abilities. Thirty-one percent of our sample (1,108 deaths) had dementia (43% mildly, 57% severely). Of those, 26% died suddenly, 59% in care home, and 74% received palliative treatment, versus 37%, 19%, and 55% in people without dementia. GP-patient conversations were less frequent among those with (45%) than those without (73%) dementia, and 11% of both groups had a proxy decision-maker. During the last week of life, physical and psychological distress was common in both groups. Of older people with dementia, 83% were incapable of decision-making and 83% were bedridden; both significantly higher percentages than found in the group without dementia (24% and 52%). Several areas of end-of-life care provision could be improved. Early communication and exploration of wishes and appointment of proxy decision-makers are important components of an early palliative care approach which appears to be initiated too infrequently.

  12. An in vitro study to evaluate the effect of storage time and application of subsequent layers on the variation in thickness of three commercially available die spacers.

    PubMed

    Jacob, Sunil J; Hegde, Chethan; Prasad, Krishna D; Shetty, Manoj

    2010-01-01

    The application of a paint-on die spacer onto the dies prior to the fabrication of cast crowns is an acceptable procedure to improve the fit of the restoration. The primary purpose of this study was to evaluate the variation in thickness of different brands of die spacer based on the effect of storage time and application of additional layers. Dies were duplicated from a master model of ivorine teeth, with a full ceramic preparation. Dies obtained were then painted with one, two, and three coats of each brand of die-spacers separately. These dies were embedded in die stone and sectioned bucco-lingually. The same procedure was done after three and six months. The thickness of the paint on die spacer was measured at five points on the die using an optical microscope, and the data were statistically analyzed. There was a definite variation in the thickness of the die spacer with all the three brands and at various points on the die. Two coat thicknesses were found to be in the range of tolerance of 20-40 microns. Thickness at occlusal groove was noted to be the maximum with least at occlusoaxial line angles. Thickness also showed a very significant increase when bottles were stored for a period of three to six months and then applied.

  13. A Study of the Training of Tool and Die Makers.

    ERIC Educational Resources Information Center

    Horowitz, Morris A.; Herrnstadt, Irwin L.

    To develop and test a methodology which would help determine the combination of education, training, and experience that is most likely to yield highly qualified workers in specific occupations, the tool and die maker trade was selected for examination in the Boston Metropolitan Area. Tool and die making was chosen because it is a clearly…

  14. 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.

  15. How people die in hospital general wards: a descriptive study.

    PubMed

    Toscani, Franco; Di Giulio, Paola; Brunelli, Cinzia; Miccinesi, Guido; Laquintana, Dario

    2005-07-01

    To describe how patients die in hospital, 370 patients (age >18 years; in hospital for>24 hours) who died on the general wards of 40 Italian hospitals were assessed. Differences between patients whose death was expected and patients whose death was unexpected were evaluated. Data on treatments and care in proximity of death were collected after interviewing the nurse responsible for the patient within 72 hours of the patient's death, and from clinical and nursing records. For 58% of patients, death was highly expected. Symptom control was inadequate for the most severely ill patients: 75% experienced at least one "severe" symptom (42% pain and 45% dyspnea). Nurses tended to judge patients' global care as "good" or "very good" (76%), in spite of the persistence of symptoms and the scant use of analgesics. Despite some encouraging signs of sensitivity to end-of-life problems, acute inpatient institutions in Italy still deal inadequately with the needs of dying persons.

  16. Dying at home or in the hospital? An observational study in German general practice.

    PubMed

    Gágyor, Ildikó; Himmel, Wolfgang; Pierau, Andrea; Chenot, Jean-François

    2016-01-01

    Although determinants of place of death have been investigated in several studies, there is a lack of knowledge on factors associated with dying at home from the general practice perspective. To identify factors associated with dying at home for patients in German general practice. In a retrospective study, general practitioners of 30 general practices were asked to provide data for all patients aged 18 years or older who died within the last 12 months, using a self-developed questionnaire. 'Dying in hospital' was defined as dying in hospital or hospice and 'dying at home' as dying at one's usual residence including the nursing home. Multiple logistic regression analyses were used to determine factors associated with 'dying at home'; odds ratios (ORs) and their 95% confidence intervals (CI) were calculated as measures of effect size. Of 439 deceased patients, 52.2% died at home, and 47.8% died in hospital or hospice. Determinants for dying at home were patients' care in the last 48 hours of life by family members (OR: 7.8, 95% CI: 3.4-18.0), by general practitioners (GPs) (OR: 7.3, 4.2-12.9) and living in a nursing home (OR: 3.8, 1.7-8.3). In the adjusted model, low comorbidity was positively associated (OR: 3.2, 1.4-7.0), and low functional health status (Karnofsky performance status) was negatively associated with dying at home (OR: 0.3, 0.1-0.7). Apart from patient-related factors such as comorbidity and health status, care by family members and GPs respectively, were determinants of dying at home.

  17. A comparative evaluation of linear dimensional accuracy of the dies obtained using three conceptually different die systems in the fabrication of implant prosthesis: an in vitro study.

    PubMed

    Ahmad, Manawar; Balakrishnan, Dhanasekar; Narayan, Aparna Ichangod

    2014-01-01

    Given that meticulous implant prosthodontic procedures are recommended to obtain the best possible intraoral fit, the die systems used for multi implant casts warrant further investigation. Die stone expansion and errors introduced by removable die casts may exceed the accuracy required for the passive fit of implant prosthesis. The purpose of the study was to evaluate the linear dimensional accuracy between the implant master die and three conceptually different die systems such as Pindex system, Accu-trac precision die system, and Conventional brass dowel pin system. Thirty impressions of implant master die were made with polyether impression material. Ten experimental implant casts were fabricated for each of the three different die systems tested: Accu-trac precision die tray system, Pindex system, and conventional brass dowel pin system. The solid experimental casts were sectioned and then removed from the die system 30 times. Linear distances between all six possible distances were measured from one centre of the transfer coping to the other, using a co-ordinate measuring machine in millimeters up to accuracy of 0.5 microns. Data were tabulated and statistically analyzed by Binomial non parametric test using SPSS version 15. Significant differences were found for distance A-B (P = 0.002), A-C ( P = 0.002), A-D (P value = 0.002), and B-D ( P = 0.021) in Conventional Dowel pin system however for Accu-trac precision die tray system, it was significant only for distance A-D (P = 0.002) but for Pindex system it was non-significant for all the distances measured. Within the limitations of this study, use of Pindex system is recommended when sectioned dies are needed for a multi implant retained prosthesis.

  18. Young Children's Probability of Dying Before and After Their Mother's Death: A Rural South African Population-Based Surveillance Study

    PubMed Central

    Clark, Samuel J.; Kahn, Kathleen; Houle, Brian; Arteche, Adriane; Collinson, Mark A.; Tollman, Stephen M.; Stein, Alan

    2013-01-01

    Background There is evidence that a young child's risk of dying increases following the mother's death, but little is known about the risk when the mother becomes very ill prior to her death. We hypothesized that children would be more likely to die during the period several months before their mother's death, as well as for several months after her death. Therefore we investigated the relationship between young children's likelihood of dying and the timing of their mother's death and, in particular, the existence of a critical period of increased risk. Methods and Findings Data from a health and socio-demographic surveillance system in rural South Africa were collected on children 0–5 y of age from 1 January 1994 to 31 December 2008. Discrete time survival analysis was used to estimate children's probability of dying before and after their mother's death, accounting for moderators. 1,244 children (3% of sample) died from 1994 to 2008. The probability of child death began to rise 6–11 mo prior to the mother's death and increased markedly during the 2 mo immediately before the month of her death (odds ratio [OR] 7.1 [95% CI 3.9–12.7]), in the month of her death (OR 12.6 [6.2–25.3]), and during the 2 mo following her death (OR 7.0 [3.2–15.6]). This increase in the probability of dying was more pronounced for children whose mothers died of AIDS or tuberculosis compared to other causes of death, but the pattern remained for causes unrelated to AIDS/tuberculosis. Infants aged 0–6 mo at the time of their mother's death were nine times more likely to die than children aged 2–5 y. The limitations of the study included the lack of knowledge about precisely when a very ill mother will die, a lack of information about child nutrition and care, and the diagnosis of AIDS deaths by verbal autopsy rather than serostatus. Conclusions Young children in lower income settings are more likely to die not only after their mother's death but also in the months before, when

  19. Student nurses' experience of and attitudes towards care of the dying: A cross-sectional study.

    PubMed

    Grubb, Catherine; Arthur, Antony

    2016-01-01

    Nurses are the professional group with the greatest contact with those at the end of life and their attitudes towards the care of the dying is important in care delivery. We investigated the relationship between student nurses' attitudes towards care of the dying and (1) demographics, (2) course factors and (3) experience of caring for people who are dying. A cross-sectional survey using the Frommelt's Attitude Toward Care of the Dying scale to measure respondents' attitudes. Nursing students studying at a university in the United Kingdom. A total of 567 completed questionnaires were returned, with 91.9% of respondents being classed as having a positive attitude towards care of the dying (Frommelt's Attitude Toward Care of the Dying score ⩾65). In adjusted analysis, higher (more positive) Frommelt's Attitude Toward Care of the Dying scores were associated with time on course and experience of caring for the dying. Third-year students had a score of 2.18 points greater than those in their first year (95% confidence interval: 0.36-4.01, p = 0.017). The adjusted differences in scores were 2.22 points greater for those who had prepared a dead body (95% confidence interval: 0.57-3.87, p = 0.008), 2.95 points greater for those who had cared for a dying patient (95% confidence interval: 1.09-4.08, p = 0.002) and 2.03 points greater for those who had cared for a dying relative or friend (95% confidence interval: 0.69-3.37, p = 0.003). The length of time in education and practical experience of caring for dying individuals are independently associated with positive attitudes towards care of the dying among student nurses. © The Author(s) 2015.

  20. Analytical and numerical study of the pressure die casting processes

    NASA Astrophysics Data System (ADS)

    Lopez Rodriguez, Joaquin

    In pressure die casting, the most common defect in manufactured parts is porosity, one of the major causes of which is air entrapment in the molten metal during the injection process. Among other factors, the correct design of the gating and venting systems and an appropriate selection of the operating conditions during the injection phase can contribute to minimizing casting porosity. In the present work, a systematic study of the operating conditions and the characteristics of the injection and venting systems (plunger motion law, initial filling fraction, shot sleeve dimensions, dimension and location of the vents, atmospheric and vacuum venting conditions, etc.) that reduce air entrapment while keeping the injection filling time as low as possible is carried out. Limiting values of the initial filling fraction required for appropriate operating conditions are also determined for wide ranges of acceleration parameters and pouring hole locations. The flow of molten metal inside the injection chamber is analyzed using a two-dimensional finite-element model and a simpler model based on the shallow-water approximation. Two commonly used types of plunger movements are considered, for which results for wave profiles, the volume (area) of entrapped air in the injection chamber, and optimum values of the parameters characterizing the law of plunger motion are presented. A new law of plunger acceleration which would completely eliminate the air from the shot sleeve at the end of the slow phase of injection and minimizes the filling time is derived. The flow through venting systems is analyzed using an unsteady model for both atmospheric and vacuum venting conditions. The model is solved numerically using the method of characteristics. The numerical results of the model agree very well with the results of previous quasi-steady models for conditions for which unsteady effects are negligible, as could be expected. The results presented in this work show that, for broad

  1. 8 CFR 319.3 - Surviving spouses of United States citizens who died during a period of honorable service in an...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... who died during a period of honorable service in an active duty status in the Armed Forces of the... status in the Armed Forces of the United States. (a) Eligibility. To be eligible for naturalization under... active duty status in the Armed Forces of the United States and, in the case of a surviving...

  2. 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…

  3. The 'dis-ease' of dying: challenges in nursing care of the dying in the acute hospital setting. A qualitative observational study.

    PubMed

    Bloomer, Melissa J; Endacott, Ruth; O'Connor, Margaret; Cross, Wendy

    2013-09-01

    Changes in health care and an ageing population have meant that more people are dying in the acute hospital setting. While palliative care principles have resulted in quality care for the dying, many patients die in an acute care, still receiving aggressive/resuscitative care. The aims were to explore nurses' 'recognition of' and 'responsiveness to' dying patients and to understand the nurses' influence on end-of-life care. A qualitative approach was taken utilising non-participant observation to elicit rich data, followed by focus groups and individual semi-structured interviews for clarification. This study was conducted in two acute medical wards in one health service, identified as having the highest rates of death, once palliative care and critical care areas were excluded. Twenty-five nurses consented to participate, and 20 episodes of observation were conducted. Nurses took a passive role in recognising dying, providing active care until a medical officer's declaration of dying. Ward design, nurse allocation and nurses' attitude to death impacts patient care. End-of-life care in a single room can have negative consequences for the dying. Nurses demonstrated varying degrees of discomfort, indicating that they were underprepared for this role. When patients are terminally ill, acknowledgement of dying is essential in providing appropriate care. It should not be assumed that all nurses are adequately prepared to provide dying care. Further work is necessary to investigate how the attitudes of nurses towards caring for dying patients in the acute hospital setting may impact care of the dying patient.

  4. Dutch pediatricians' views on the use of neuromuscular blockers for dying neonates: a qualitative study.

    PubMed

    ten Cate, K; van de Vathorst, S

    2015-07-01

    To assess Dutch pediatricians' views on neuromuscular blockers for dying neonates. Qualitative study involving in-depth interviews with 10 Dutch pediatricians working with severely ill neonates. Data were analyzed using appropriate qualitative research techniques. Participants explained their view on neuromuscular blockers for neonates with a protracted dying process. Major themes were the interpretation of gasping, the role of (the suffering of) the parents, the need for judicial review and legislation's impact on the care participants provide for dying neonates. The interviews show no consensus between pediatricians and provide insights into the points of disagreement. Interviews also suggest friction between the convictions of pediatricians and legislation, which seems to have an undesirable impact on Dutch care for dying neonates and their parents. This study raises important questions for pediatricians worldwide to reflect upon, such as: 'what constitutes 'dying well'?' and 'what role should the parents' perspective play?'.

  5. Study on stretching effect of multiple die forming technology

    NASA Astrophysics Data System (ADS)

    Park, Ji-woo; Kim, Jeong; Kang, Beom-soo

    2013-12-01

    The multiple die forming (MDF) technology is suitable for flexible manufacturing, and it affords several advantages including its applicability to various forming processes such as single-curved surface forming, and double-curved surface forming. In sheet metal forming process, the elastic recovery has become a problem. Therefore, the stretch forming process is applied MDF technology to reduce elastic recovery effect. Numerical simulation is carried out for a saddle-type surface forming using ABAQUS. Every simulation case performs spring-back analysis to find elastic recovery effect after forming simulation. In this simulation, urethane pads are defined based on a hyperelastic material model as a cushion for the smoothness of forming surface. The elastic recovery deformation behavior is also investigated to consider the exact result after the last forming process, and then, the actual experiments are performed to confirm the formability of this forming process. By comparing the simulation and the experimental results, the tendency of the decreased amount of elastic recovery from the application of stretch process is verified. Consequently, it is confirmed that the multiple die stretch forming process has the capability and feasibility of being used to manufacture the curved surfaces of sheet metal.

  6. Exploiting Defect Clustering to Screen Bare Die for Infant Mortality Failure: An Experimental Study

    NASA Technical Reports Server (NTRS)

    Lakin, David R., II; Singh, Adit D.

    1999-01-01

    We present the first experimental results to establish that a binning strategy based on defect clustering can be used to screen bare die for early life failures. The data for this study comes from the SEMATECH test methods experiment.

  7. Exploiting Defect Clustering to Screen Bare Die for Infant Mortality Failure: An Experimental Study

    NASA Technical Reports Server (NTRS)

    Lakin, David R., II; Singh, Adit D.

    1999-01-01

    We present the first experimental results to establish that a binning strategy based on defect clustering can be used to screen bare die for early life failures. The data for this study comes from the SEMATECH test methods experiment.

  8. Study of Thermal Fatigue of H13 Die Steel with Various Surface Treatments

    NASA Astrophysics Data System (ADS)

    Ivanov, V. V.; Ferguson, W. G.; Paine, I. R.

    Surfaces of die-casting dies are subjected to very severe conditions of cyclical thermal and mechanical load, and chemical and mechanical wear. Dies mostly fail due to a combination of heat checking, erosion, corrosion and soldering. It is conceivable that appropriate surface treatments and coatings have a favourable influence on the temperature dependant performance of the surface of the die. The objective of this study was to examine various surface treatments and coatings. including shot peening, nitriding, nitro-carburizing, laser hardening and remelting, electro-spark alloying (deposition) and plasma spraying, under thermal fatigue conditions. Thermal cycling tests were conducted by alternate dipping of treated samples in an LM24 melt and in water. Results and interpretation are presented in this paper. The best thermal fatigue resistance was shown for a double surface treatment of laser hardening plus electro-spark deposition.

  9. Sputtered protective coatings for die casting dies

    NASA Technical Reports Server (NTRS)

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

    1981-01-01

    This investigation determined whether selected ion beam sputtered coatings on H-13 die steel would have the potential of improving the thermal fatigue behavior of the steel used as a die in aluminum die casting. The coatings were selected to test candidate insulators and metals capable of providing protection of the die surface. The studies indicate that 1 micrometer thick W and Pt coatings reduced the thermal fatigue more than any other coating tested and are candidates to be used on a die surface to increase die life.

  10. Understanding why older people develop a wish to die: a qualitative interview study.

    PubMed

    Rurup, M L; Pasman, H R W; Goedhart, J; Deeg, D J H; Kerkhof, A J F M; Onwuteaka-Philipsen, B D

    2011-01-01

    Quantitative studies in several European countries showed that 10-20% of older people have or have had a wish to die. To improve our understanding of why some older people develop a wish to die. In-depth interviews with people with a wish to die (n = 31) were carried out. Through open coding and inductive analysis, we developed a conceptual framework to describe the development of death wishes. Respondents were selected from two cohort studies. The wish to die had either been triggered suddenly after traumatic life events or had developed gradually after a life full of adversity, as a consequence of aging or illness, or after recurring depression. The respondents were in a situation they considered unacceptable, yet they felt they had no control to change their situation and thus progressively "gave up" trying. Recurring themes included being widowed, feeling lonely, being a victim, being dependent, and wanting to be useful. Developing thoughts about death as a positive thing or a release from problems seemed to them like a way to reclaim control. People who wish to die originally develop thoughts about death as a positive solution to life events or to an adverse situation, and eventually reach a balance of the wish to live and to die.

  11. Marginal discrepancy as affected by selective placement of die-spacer: an in vitro study.

    PubMed

    Aditya, Priyam; Madhav, V N V; Bhide, S V; Aditya, Amita

    2012-09-01

    An increase in the marginal discrepancy is seen after cementation with a luting agent and provision of cement space with a die-spacer is the most preferred method to avoid it. Recommended thickness of die-spacer is 25-40 μm. Smaller die-spacer thickness was consistently found at the axio-occlusal line angles as compared to the other surfaces which has been postulated to that the spacer paint tends to flow away from the sharp line angles and cusp tips as a result of increased surface tension. The absence of adequate relief spaces in these areas impedes the flow of cement beyond the occlusal portion of the casting, which would result in incomplete seating because of hydraulic pressure. Fifty stone dies were duplicated from a steel die and were divided into five groups of sample size 10, where the die-spacer was selectively placed. Measurements were taken at four points, 90° apart from each other with the help of optical microscope. Later all the castings were cemented using Glass Inomer cement as a luting agent, under a 10 kg static load and measurements were recorded. Statistical analysis showed samples with no spacer had the maximum pre and post cementation gap while the least discrepancy was seen in group with additional layer of die-spacer painted over the axio-occlusal line angle. The results were highly significant which clearly indicated the superiority of this group over others. Within limitations of the study, it can be said that application of additional layer of die-spacer at the axio-occlusal line angle will help in decreasing the post cementation marginal discrepancy in full cast metal crowns.

  12. Dying in hospital with dementia and pneumonia: a nationwide study using death certificate data.

    PubMed

    Houttekier, Dirk; Reyniers, Thijs; Deliens, Luc; Van Den Noortgate, Nele; Cohen, Joachim

    2014-01-01

    For people with dementia dying from pneumonia, hospitalization at the end of life may be of little benefit and result in unfavourable outcomes such as hospital death. The aim of this study is to estimate the incidence of and factors associated with hospital death in people with dementia dying from pneumonia. We used death certificate data of all deaths in Belgium in 2008 (n = 101,685) to examine characteristics of deaths of people with dementia dying from pneumonia. Information about the urbanization level of the place of residence and the availability of hospital beds, residential (without continuous skilled nursing) and skilled nursing beds in long-term care settings was linked through the zip code of the place of residence. Of people with dementia dying from pneumonia (n = 1,420), 47.2% died in hospital. Of those living in long-term care settings, 25.6% died in hospital. For people living in their own home, hospital death was more likely for those who were single (adjusted odds ratio (AOR) 2.83, 95% CI 1.30-6.16) and living in strongly urbanized areas (AOR 2.48, 95% CI 1.47-4.18). For those living in long-term care settings, hospital death was more likely in regions with higher availability of residential beds (without continuous skilled nursing) in long-term care settings (AOR per unit 1.02, 95% CI 1.01-1.03). Almost half of all those with dementia dying from pneumonia and a quarter of those living in long-term care settings died in a hospital. These results suggest shortcomings in the Belgian healthcare system in preventing potentially avoidable terminal hospitalizations in a vulnerable population.

  13. 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.

  14. Periodization

    PubMed Central

    Lorenz, Daniel S.; Reiman, Michael P.; Walker, John C.

    2010-01-01

    Background: Clinicians are constantly faced with the challenge of designing training programs for injured and noninjured athletes that maximize healing and optimize performance. Periodization is a concept of systematic progression—that is, resistance training programs that follow predictable patterns of change in training variables. The strength training literature is abundant with studies comparing periodization schemes on uninjured, trained, and untrained athletes. The rehabilitation literature, however, is scarce with information about how to optimally design resistance training programs based on periodization principles for injured athletes. The purpose of this review is to discuss relevant training variables and methods of periodization, as well as periodization program outcomes. A secondary purpose is to provide an anecdotal framework regarding implementation of periodization principles into rehabilitation programs. Evidence Acquisition: A Medline search from 1979 to 2009 was implemented with the keywords periodization, strength training, rehabilitation, endurance, power, hypertrophy, and resistance training with the Boolean term AND in all possible combinations in the English language. Each author also undertook independent hand searching of article references used in this review. Results: Based on the studies researched, periodized strength training regimens demonstrate improved outcomes as compared to nonperiodized programs. Conclusions: Despite the evidence in the strength training literature supporting periodization programs, there is a considerable lack of data in the rehabilitation literature about program design and successful implementation of periodization into rehabilitation programs. PMID:23015982

  15. Undergraduate nursing students' attitudes and preparedness toward caring for dying persons - A longitudinal study.

    PubMed

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

    2017-09-01

    Nursing education needs to prepare students for care of dying patients. The aim of this study was to describe the development of nursing students' attitudes toward caring for dying patients and their perceived preparedness to perform end-of-life care. A longitudinal study was performed with 117 nursing students at six universities in Sweden. The students completed the Frommelt Attitude Toward Care of the Dying Scale (FATCOD) questionnaire at the beginning of first and second year, and at the end of third year of education. After education, the students completed questions about how prepared they felt by to perform end-of-life care. The total FATCOD increased from 126 to 132 during education. Five weeks' theoretical palliative care education significantly predicted positive changes in attitudes toward caring for dying patients. Students with five weeks' theoretical palliative care training felt more prepared and supported by the education to care for a dying patient than students with shorter education. A minority felt prepared to take care of a dead body or meet relatives. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Non-Periodic Helix TWT Study.

    DTIC Science & Technology

    1980-05-01

    IA-A087 413 LITTON SYSTEMS INC SAN CARLOS CA ELECTRON TUBE DIV F/6 9/1 NON-PERIODIC HELIX TWT STUDY.(U) MAY 80 N00173-76C-014 UNCLASSIFIED ML...IEEEEEEmhEEI U-80 - ’l////////,, 11111 128 25 L1. = *""L 1- 1.8 MICROCOPY RESOLUTION TEST CHART ’IT-, ( (NO-PERIODIC HELIX WTSTUDY0 I EXTENSION OF CONTRACT... Helix Circuit 4 - 2 Non-Periodic Helix Structure 7 3 Unwound Tape for Non-Periodic Helix 8 4 Typical Helix Assembly 10 5 Typical Ladder Assembly 11 6

  17. Study of protective coatings for aluminum die casting molds

    NASA Astrophysics Data System (ADS)

    Peter, Ildiko; Rosso, Mario; Gobber, Federico Simone

    2015-12-01

    In this paper, the development and characterization of some protective coatings on steel substrate are presented. The coatings are realized by plasma spray techniques. The substrate material used is a Cr-Mo-V based hot work tool steel, initially submitted to vacuum heat treatment to achieve homogeneous hardness. The main attention is focused on the study of wear and on the characterization of the interface between the substrate material and the coating layer, because of their key role in determining the resistance of the coating layer. Simulation of friction and wear processes is performed by pin-on-disk test and the tested samples are observed by scanning electron microscopy.

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

    PubMed

    Pacsi, Alsacia L

    2008-01-01

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

  19. [Dying with dignity. A study of living wills].

    PubMed

    Nebot, Cristina; Ortega, Blas; Mira, José Joaquín; Ortiz, Lidia

    2010-01-01

    To describe the profile of persons who exercise their right to draw up a living will, to analyze physicians' knowledge of living wills and attitudes toward them, and to compare the regulations pertaining to this right in the distinct autonomous regions of Spain. A descriptive study that included an analysis of a systematic sample of 931 living wills registered in the autonomous region of Valencia (Spain), a self-administered structured questionnaire administered to a sample of 84 physicians working in emergency departments and intensive care units (45% response rate), and a comparison of the regional legislation covering living wills. A total of 1.6% of inhabitants aged 16 or over had registered a living will (female/male ratio: 1.8/1). Most (73.8%) used a standard document drawn up by a particular religious faith. The most common reasons for writing a living will were to limit therapeutic efforts (99%) and obtain pain-relieving drugs (98%). Although 61 physicians (72.6%) frequently attended the terminally ill, only 6% consulted the register of living wills in these situations and 28% did not know how to consult this register. There is wide variation among regions in the minimum age for registering a living will, in the procedure to be followed if the signer is pregnant, in designating a person as having the authority to make a living will, and in the number of registration points available to deposit living wills. Most persons registering a living will are healthy individuals with a particular religious faith who reject certain treatments. Most health professionals do not check whether critically ill patients have made a living will. Exercising the rights contained in living wills is complicated by the diversity of criteria among different regions. Copyright © 2009 SESPAS. Published by Elsevier Espana. All rights reserved.

  20. Analog Studies of Thermomechanical Fatigue and Abrasive Wear of Cast and Forged Steels for "Autoforge" Dies

    NASA Astrophysics Data System (ADS)

    Kolesnikov, M. S.; Mironova, Yu. S.; Mukhametzyanova, G. F.; Novikova, I. E.; Novikov, V. Yu.

    2014-07-01

    Processes of thermomechanical fatigue and abrasive wear of suspension-cast precipitation-hardening ferrite-carbide steel 30T6NTiC-1.5 and standard steel 4Kh5MFS are studied. The dominant kinds of fracture typical for dies for semisolid stamping are determined. The factors and parameters of cyclic temperature and force loading are shown to produce a selective action on the competing kinds of damage of the die steels. A comparative analysis of the properties of the steels is performed. Steel 30T6NTiC-1.5 is shown to have substantial advantages over steel 4Kh5FMS traditionally used for making "Autoforge" dies.

  1. Comparison of dimensional accuracy of four different die materials before and after disinfection of the impression: an in vitro study.

    PubMed

    Nandini, Yamini; Vinitha, K B; Manvi, Supriya; Smitha, M

    2013-07-01

    This study was conducted to compare the linear dimensional accuracy of die materials before and after disinfection of the impression. Type IV and V conventional dental stone, type IV-resin impregnated and copper-plated die materials were studied. A stainless-steel master die analogs to a complete veneer crown preparation with three scribed lines (I: vertical, II and III: horizontal) was machined and measurements were made from these scribed reference lines. Impressions were made with monophase addition silicone impression material for each of the specimens. 2% glutaraldehyde was used as a disinfectant. The fabricated dies were measured to the nearest 0.0001 mm. ANOVA and post hoc was carried out using Scheffe multiple comparison test at significance level of 0.05. Type IV resin-impregnated dental stone and copperplated dies approximated the dimensions of the master die. Type IV and V conventional dental stone dies showed greater variation in measurements. Statistically significant differences were observed for type IV resin-impregnated and copper-plated dies in dimension I and III. For dimension II no significant differences were found for dies fabricated from four die materials. A one-way analysis of variance indicated no statistical significant differences among the two groups of dies fabricated from disinfectant treated impressions and those fabricated from nondisinfectant treated impressions. Type IV resin-impregnated dental stone and copper-plated dies are dimensionally more accurate than type IV and V conventional dental stone die materials. No significant linear distortion in the dies fabricated from the disinfected impressions was observed.

  2. 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,…

  3. Death and Dying Attitudes, Anxieties, and Fears of Certified Nursing Assistants: A Descriptive Study

    ERIC Educational Resources Information Center

    Hamilton, Josephine A.

    2010-01-01

    The critical role of Certified Nursing Assistants (CNAs) to help elderly nursing home residents' move through declining conditions or diseases to death is salient. It is important for CNAs and nursing home leaders to understand CNAs' attitudes, fears, and anxieties toward death and dying. The quantitative study investigated CNA's…

  4. Death and Dying Attitudes, Anxieties, and Fears of Certified Nursing Assistants: A Descriptive Study

    ERIC Educational Resources Information Center

    Hamilton, Josephine A.

    2010-01-01

    The critical role of Certified Nursing Assistants (CNAs) to help elderly nursing home residents' move through declining conditions or diseases to death is salient. It is important for CNAs and nursing home leaders to understand CNAs' attitudes, fears, and anxieties toward death and dying. The quantitative study investigated CNA's…

  5. Effect of palliative care nurse champions on the quality of dying in the hospital according to bereaved relatives: A controlled before-and-after study.

    PubMed

    Witkamp, Frederika Erica; van Zuylen, Lia; van der Rijt, Carin C D; van der Heide, Agnes

    2016-02-01

    To improve the quality of end-of-life care, hospitals increasingly appoint palliative care nurse champions. We investigated the effect of nurse champions on the quality of life during the last 3 days of life and the quality of dying as experienced by bereaved relatives. A controlled before-and-after study (June 2009-July 2012). Halfway, in each of seven intervention wards, two nurse champions were appointed; 11 wards served as control wards. The quality of life during the last 3 days of life, quality of dying and multiple dimensions of quality of dying were compared before and after the introduction of nurse champions. In a university hospital, each death at non-intensive care units was followed up by an invitation to relatives (10-13 weeks later) to answer a questionnaire. For the two periods, data were collected on 86 and 84 patients in intervention wards and on 108 and 118 patients in control wards (overall response: 52%). In the intervention wards, no differences were found in the quality of life during the last 3 days of life and the quality of dying scores: in both periods, median score for the quality of life during the last 3 days of life was 3.0 and for the quality of dying 7.0. No differences were found in multiple quality of dying dimensions. In control wards, the median quality of dying score was 7.0 pre-intervention and 6.0 post-intervention (p = 0.04). Other scores were comparable with those in intervention wards. Performing a complex intervention study in palliative care proved to be feasible. This study showed no differences in the experiences of bereaved relatives after introduction of nurse champions. The complexity of palliative care in the hospital might require more intensive and longer training of nurse champions. © The Author(s) 2015.

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

    PubMed

    Andersson, Erika; Salickiene, Zivile; Rosengren, Kristina

    2016-03-01

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

  7. Does Ethnicity Affect Where People with Cancer Die? A Population-Based 10 Year Study

    PubMed Central

    Koffman, Jonathan; Ho, Yuen King; Davies, Joanna; Gao, Wei; Higginson, Irene J.

    2014-01-01

    Background Ageing is a growing issue for people from UK black, Asian and minority ethnic (BAME) groups. The health experiences of these groups are recognised as a ‘tracer’ to measure success in end of life patient-preferred outcomes that includes place of death (PoD). Aim To examine patterns in PoD among BAME groups who died of cancer. Material and Methods Mortality data for 93,375 cancer deaths of those aged ≥65 years in London from 2001–2010 were obtained from the UK Office for National Statistics (ONS). Decedent's country of birth was used as a proxy for ethnicity. Linear regression examined trends in place of death across the eight ethnic groups and Poisson regression examined the association between country of birth and place of death. Results 76% decedents were born in the UK, followed by Ireland (5.9%), Europe(5.4%) and Caribbean(4.3%). Most deaths(52.5%) occurred in hospital, followed by home(18.7%). During the study period, deaths in hospital declined with an increase in home deaths; trend for time analysis for those born in UK(0.50%/yr[0.36–0.64%]p<0.001), Europe (1.00%/yr[0.64–1.30%]p<0.001), Asia(1.09%/yr[0.94–1.20%]p<0.001) and Caribbean(1.03%/yr[0.72–1.30%]p<0.001). However, time consistent gaps across the geographical groups remained. Following adjustment hospital deaths were more likely for those born in Asia(Proportion ratio(PR)1.12[95%CI1.08–1.15]p<0.001) and Africa(PR 1.11[95%CI1.07–1.16]p<0.001). Hospice deaths were less likely for those born in Asia(PR 0.73 [0.68–0.80] p<0.001), Africa (PR 0.83[95%CI0.74–0.93]p<0.001), and ‘other’ geographical regions (PR0.90[95% 0.82–0.98]p<0.001). Home deaths were less likely for those born in the Caribbean(PR0.91[95%CI 0.85–0.98]p<0.001). Conclusions Location of death varies by country of birth. BAME groups are more likely to die in a hospital and less likely to die at home or in a hospice. Further investigation is needed to determine whether these differences result from

  8. 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

  9. Telemedicine's Potential to Support Good Dying in Nigeria: A Qualitative Study.

    PubMed

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

    2015-01-01

    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. 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. 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. 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 palliative care in Africa. Telemedicine can only help if low

  10. 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

  11. [Living and dying in community based housing for people with dementia. An exploratory qualitative study].

    PubMed

    Reitinger, E; Pleschberger, S; Schumann, F

    2010-10-01

    Community based housing for people with dementia is gaining importance. In co-operation between the people concerned, their relatives, professionals and volunteers, person-centred care, nursing and guidance can be realised within small units. Questions regarding end of life, dying, grief and the role of palliative care form the basis of the exploratory qualitative study presented here. Coping with end of life, ethical decisions and the relevance of hospice and palliative care in the field are highlighted. The results of the study show that "shared flats for people with dementia" are good places for death and dying. Close relationships, good communication with relatives and highly motivated professionals can be regarded as powerful resources. So far only few co-operations between hospice and palliative care exist. Areas of improvement encompass clinical issues and coping with bereavement.

  12. Sleep complaints associated with wish to die after a suicide crisis-an exploratory study.

    PubMed

    Mirsu-Paun, Anca; Jaussent, Isabelle; Komar, Giovanni; Courtet, Philippe; Lopez-Castroman, Jorge

    2017-04-24

    The present study explores whether sleep concerns are associated with wish to die throughout a 1-month time interval following a suicide crisis. Sixty-eight patients admitted to the emergency department of a general or psychiatric hospital were enrolled. Sleep difficulties were assessed using the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale, self-reported satisfaction with sleep and time in bed. Suicidal ideation was assessed through the presence of a wish to die at 1 month following a suicide crisis. Co-existing psychiatric diagnoses were assessed using the French version of the Mini International Neuropsychiatric Interview (MINI). Potential covariate factors such as personal and family history of suicidal behaviours and sociodemographic variables were accounted for. We found that wish to die was associated significantly with insomnia severity, low satisfaction with sleep and sleep duration 1 month after the suicide crisis, even after controlling for covariates. This exploratory study is limited by a small sample size, and results cannot be generalized to patients with psychotic disorders or alcohol use disorders. Also, other factors related potentially to suicidal ideation, such as depression severity, stressful events or levels of family support, were not accounted for. However, overall our study supports the assessment of sleep complaints as a potential indicator of suicide risk in the weeks that follow a suicide crisis. © 2017 European Sleep Research Society.

  13. 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.

  14. Study of radial die-wall pressure during high speed tableting: effect of formulation variables.

    PubMed

    Abdel-Hamid, Sameh; Koziolek, Mirko; Betz, Gabriele

    2012-05-01

    With high-speed compaction cycles as applied in pharmaceutical industrial presses, robust tools like radial die-wall pressure (RDWP) are required to monitor the deformation behavior of formulations under pressure and to avoid common problems such as capping. In this study, the effects of common formulation factors such as lubricant, binder, and drug loading on RDW were investigated. Compaction simulation using Presster™ was applied for five pharmaceutical fillers with different compaction behaviors. Two lubricants, two binders and paracetamol as a model drug were used. Residual die-wall (RDP) and other compaction parameters were measured. Lubricant reduced RDP for fillers with plastic/brittle behavior(s), (p < 0.05), while increased RDP for fillers with plastic/elastic behavior, (p < 0.05), leading to higher tendency for capping in the later fillers. Binder reduced RDP for the fillers, (p < 0.05), hence, decreased capping probability. By increasing drug loading for fillers with plastic/elastic behavior(s), RDP was increased, (p = 0.00001), leading to capping, especially at high compaction pressure and speed. Die-wall instrumentation was useful in investigating formulation variables and detecting capping during high speed tableting.

  15. End of Life Care for Patients Dying of Stroke: A Comparative Registry Study of Stroke and Cancer.

    PubMed

    Eriksson, Heléne; Milberg, Anna; Hjelm, Katarina; Friedrichsen, Maria

    2016-01-01

    Although stroke is a significant public health challenge and the need for palliative care has been emphasized for these patients, there is limited data on end-of-life care for patients dying from stroke. To study the end-of-life care during the last week of life for patients who had died of stroke in terms of registered symptom, symptom management, and communication, in comparison with patients who had died of cancer. This study is a retrospective, comparative registry study. A retrospective comparative registry study was performed using data from a Swedish national quality register for end-of-life care based on WHO`s definition of Palliative care. Data from 1626 patients who had died of stroke were compared with data from 1626 patients who had died of cancer. Binary logistic analyses were used to calculate odds ratios, with 95% CI. Compared to patients who was dying of cancer, the patients who was dying of stroke had a significantly higher prevalence of having death rattles registered, but a significantly lower prevalence of, nausea, confusion, dyspnea, anxiety, and pain. In addition, the stroke group had significantly lower odds ratios for health care staff not to know whether all these six symptoms were present or not. Patients who was dying of stroke had significantly lower odds ratio of having informative communication from a physician about the transition to end-of-life care and of their family members being offered bereavement follow-up. The results indicate on differences in end-of-life care between patients dying of stroke and those dying from cancer. To improve the end-of-life care in clinical practice and ensure it has consistent quality, irrespective of diagnosis, education and implementation of palliative care principles are necessary.

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

    SciTech Connect

    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 and 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.

  17. MR LLRF VXI upgrade beam study period

    SciTech Connect

    Mesiner, K.; /Fermilab

    1995-01-01

    AD/RFI/LLRF group personnel performed several studies with the MR LLRF VXI upgrade system during the evening of 7/29/95. The study period lasted about 4 hours. The MR operating conditions were a mixture of $29 and $2B cycles, with beam injected only on the $29. The author believes the $2B cycles were present for reasons unrelated to the study. The basic study period goal was to test the initial VXI version of MR LLRF finite state machine (FSM) execution. This goal represents what has been called MR LLRF VXI Upgrade Implementation Stage No.2 throughout presentations and documentation on the upgrade project. The test includes control of MR LLRF NIM hardware, the MR RF cavities, and beam via XVI TTL FSM outputs. Numerous MR LLRF VXI system objects, or components, must work together correctly for a successful test. Very briefly, the required objects include VXI Front End hardware, the ACNET/Front End interface code, and the VXI/NIM Interface chassis (the chassis solves VXI-CAMAC-NIM RF and FSM output connectivity and development problems). Though this initial FSM does not yet fully support Upgrade Implementation Stage 2 functionality, all code and hardware for the following basic functionality is tested.

  18. A comparative evaluation of application techniques of a paint-on die spacer in grooves: an in vitro study.

    PubMed

    Vaishali, K; Prasad, D Krishna; Shetty, Manoj

    2013-12-01

    The use of paint-on die spacer to improve the seating of casting has become quite popular in the recent years. The generally accepted range of paint-on die spacer is approximately 20-40 μm, which suggests a range of tolerance. The painting of the retentive grooves with die spacer has always been a subject of debate. The primary purpose of this study was to determine if there was a tendency for the paint-on die spacer to accumulate in grooves of tooth preparation in sufficient thickness to exceed this accepted range of tolerance when applied using two different techniques. Eight die stone blocks with three grooves each were prepared. Half the samples were painted in unidirectional method and the other halves were painted using the haphazard method of application. The thickness of the die spacer was measured at different positions using 200× magnification and the mean and standard deviations were calculated. On analysis it was seen that the thickness of the paint-on die spacer in grooves was in the range of 20-40 μm for unidirectional method of application, whereas in haphazard method of application the thickness of the paint-on die spacer was in the range of 28-132 μm. From the above study it was concluded that the method of application influenced the thickness of the paint-on die spacer. The recommended thickness of the die spacer was achieved on unidirectional method of application.

  19. Topological study of the periodic system.

    PubMed

    Restrepo, Guillermo; Mesa, Héber; Llanos, Eugenio J; Villaveces, José L

    2004-01-01

    We carried out a topological study of the Space of Chemical Elements, SCE, based on a clustering analysis of 72 elements, each one defined by a vector of 31 properties. We looked for neighborhoods, boundaries, and other topological properties of the SCE. Among the results one sees the well-known patterns of the Periodic Table and relationships such as the Singularity Principle and the Diagonal Relationship, but there appears also a robustness property of some of the better-known families of elements. Alkaline metals and Noble Gases are sets whose neighborhoods have no other elements besides themselves, whereas the topological boundary of the set of metals is formed by semimetallic elements.

  20. How Deltas Die - a Case Study of the End of Sedimentation in Two Giant Deltas

    NASA Astrophysics Data System (ADS)

    Macdonald, D.; Robinson, P.; Nicholson, U.

    2013-12-01

    Most well-studied deltas are on passive margins (e.g. Mississippi, Rhone, Ebro), where the main tectonic control on accommodation space is thermal subsidence. As long as the main river in the sediment routing system keeps flowing, there is no particular reason for sedimentation to end, and some deltas have a history extending more than 100 Ma (e.g. Niger at 130 Ma). However, some very large deltas can build out over active margins. For example, the Amur, Orinoco, and Colorado (US) deltas all straddle strike-slip plate boundaries and are much less long-lived than their passive margin counterparts. This paper looks in detail at the end of the deltaic sedimentation in the Pliocene deltas of the Amur River on the island of Sakhalin, and the Colorado River in the Fish Creek-Vallecito Basin of southern California. In both cases the deltas are sand-rich with distant provenances in East Asia and the Colorado Plateau respectively; also they both coexist with locally derived clastic sedimentation. Despite these similarities, there are significant differences between the two deltas as a direct result of the differences in plate boundary movement rates and tectonic state. On Sakhalin, the plate boundary has moved at about 1.95 mm a-1 during the Pliocene and has been in a transpressional state. Primary deltaic sedimentation ended by a three main mechanisms: uplift of the island along the transpressional plate boundary detached the delta from the trunk stream; growth of anticlines over strands of the plate boundary disrupted the consequent delta-top drainage; and late sedimentation involved reworking of the far-travelled deltaic material. In California, where the plate boundary has moved at about 50 mm a-1 in the Pliocene, deltaic sedimentation ceased by translation of the receiving basin from the river mouth. New field and mineralogical data suggest that Colorado River sedimentation waned over a period of about 1 Ma in the Late Pliocene, and was gradually overwhelmed by locally

  1. The fear of dying and occurrence of posttraumatic stress symptoms after an acute coronary syndrome: A prospective observational study.

    PubMed

    Malinauskaite, Ieva; Slapikas, Rimvydas; Courvoisier, Delphine; Mach, François; Gencer, Baris

    2017-02-01

    The purpose of the study was to investigate whether experiencing fear of dying after acute coronary syndrome predicts later posttraumatic stress symptoms. We enrolled 90 patients hospitalized with main diagnosis of acute coronary syndrome and assessed baseline characteristics. One month after discharge, we collected the Posttraumatic Stress Scale. A total of 24 patients (26.7%) developed posttraumatic stress symptoms 1 month after the acute coronary syndrome event. Patients with posttraumatic stress symptoms reported significantly greater fear of dying, helplessness, avoidance-focused coping, and severe anxiety. In our prospective study, fear of dying was associated with occurrence of posttraumatic stress symptoms in patients hospitalized with acute coronary syndrome.

  2. Periodical Use Study. Report No. 6.

    ERIC Educational Resources Information Center

    Brown, Nancy; Cho, Yong-Ja

    Faced with growing problems in the management and direction of its periodical collection, in 1973 the McLaughlin Library at the University of Guelph established a Periodical Use Committee responsible for collecting and analyzing statistics on the use of periodicals within the library. Specific responsibilities of the committee included deciding…

  3. 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.

  4. The suffering in silence of older parents whose child died of cancer: A qualitative study.

    PubMed

    Van Humbeeck, Liesbeth; Dillen, Let; Piers, Ruth; Grypdonck, Mieke; Van Den Noortgate, Nele

    2016-01-01

    As life expectancy grows, the death of an adult child becomes a highly prevalent problem for older adults. The present study is based on nine interviews and explores the experience of parents (≥70 years) outliving an adult child. The bereaved parents described some silencing processes constraining their expression of grief. When an adult dies, the social support system nearly automatically directs its care towards the bereaved nuclear family. Parental grief at old age is therefore often not recognized and/or acknowledged. Health care providers should be sensitive to the silent grief of older parents both in geriatric and oncology care settings.

  5. The challenge of consolation: nurses' experiences with spiritual and existential care for the dying-a phenomenological hermeneutical study.

    PubMed

    Tornøe, Kirsten Anne; Danbolt, Lars Johan; Kvigne, Kari; Sørlie, Venke

    2015-01-01

    A majority of people in Western Europe and the USA die in hospitals. Spiritual and existential care is seen to be an integral component of holistic, compassionate and comprehensive palliative care. Yet, several studies show that many nurses are anxious and uncertain about engaging in spiritual and existential care for the dying. The aim of this study is to describe nurses' experiences with spiritual and existential care for dying patients in a general hospital. Individual narrative interviews were conducted with nurses in a medical and oncological ward. Data were analyzed using a phenomenological hermeneutical method. The nurses felt that it was challenging to uncover dying patients' spiritual and existential suffering, because it usually emerged as elusive entanglements of physical, emotional, relational, spiritual and existential pain. The nurses' spiritual and existential care interventions were aimed at facilitating a peaceful and harmonious death. The nurses strove to help patients accept dying, settle practical affairs and achieve reconciliation with their past, their loved ones and with God. The nurses experienced that they had been able to convey consolation when they had managed to help patients to find peace and reconciliation in the final stages of dying. This was experienced as rewarding and fulfilling. The nurses experienced that it was emotionally challenging to be unable to relieve dying patients' spiritual and existential anguish, because it activated feelings of professional helplessness and shortcomings. Although spiritual and existential suffering at the end of life cannot be totally alleviated, nurses may ease some of the existential and spiritual loneliness of dying by standing with their patients in their suffering. Further research (qualitative as well as quantitative) is needed to uncover how nurses provide spiritual and existential care for dying patients in everyday practice. Such research is an important and valuable knowledge supplement

  6. Are gender and life attitudes associated with the wish to die in older psychiatric and somatic inpatients? An explorative study.

    PubMed

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

    2014-10-01

    Death wishes are not uncommon in older persons, and to date, several risk factors have been identified. The presence of these risk factors is insufficient to fully understand why some older people, who are exposed to them, develop a wish to die and why others do not. The purpose of the study was to explore whether Purpose in Life as well as other life attitudes are associated with a death wish in older males and females. 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 SCID-II. Logistic regression analyses estimated the unique contribution of (the interaction between) life attitudes and gender to the wish to die, controlling for sociodemographic variables, depressive disorder, and somatic symptoms. We observed a statistically significant relationship between life attitudes and the wish to die. Purpose in Life and the Purpose in Life*Gender interaction explained significant additional variance in the prediction of the wish to die. Purposelessness in life might therefore be an important correlate of a wish to die, especially in older men, independently from sociodemographic and clinical features. In assessing a wish to die in older adults, life attitudes need to be taken into account, besides the presence of a depressive disorder and/or somatic health. More specifically, finding or maintaining a purpose in later life might be an important feature in the prevention of the wish to die, especially in male persons.

  7. The study of flow pattern and phase-change problem in die casting process

    NASA Technical Reports Server (NTRS)

    Wang, T. S.; Wei, H.; Chen, Y. S.; Shang, H. M.

    1996-01-01

    The flow pattern and solidification phenomena in die casting process have been investigated in the first phase study. The flow pattern in filling process is predicted by using a VOF (volume of fluid) method. A good agreement with experimental observation is obtained for filling the water into a die cavity with different gate geometry and with an obstacle in the cavity. An enthalpy method has been applied to solve the solidification problem. By treating the latent heat implicitly into the enthalpy instead of explicitly into the source term, the CPU time can be reduced at least 20 times. The effect of material properties on solidification fronts is tested. It concludes that the dependence of properties on temperature is significant. The influence of the natural convection over the diffusion has also been studied. The result shows that the liquid metal solidification phenomena is diffusion dominant, and the natural convection can affect the shape of the interface. In the second phase study, the filling and solidification processes will be considered simultaneously.

  8. A study on the reliability of indium solder die bonding of high power semiconductor lasers

    NASA Astrophysics Data System (ADS)

    Liu, Xingsheng; Davis, Ronald W.; Hughes, Lawrence C.; Rasmussen, Michael H.; Bhat, Rajaram; Zah, Chung-En; Stradling, Jim

    2006-07-01

    High power semiconductor lasers have found increased applications. Indium solder is one of the most widely used solders in high power laser die bonding. Indium solder has some advantages in laser die bonding. It also has some concerns, however, especially in terms of reliability. In this paper, the reliability of indium solder die bonding of high power broad area semiconductor lasers was studied. It was found that indium solder bonded lasers have much shorter lifetime than AuSn solder bonded devices. Catastrophic degradation was observed in indium solder bonded lasers. Nondestructive optical and acoustic microscopy was conducted during the lifetime testing to monitor the failure process and destructive failure analysis was performed after the lasers failed. It was found that the sudden failure was caused by electromigration of indium solder at the high testing current of up to 7A. It was shown that voids were created and gradually enlarged by indium solder electromigration, which caused local heating near the facets of the laser. The local heating induced catastrophic optical mirror damage (COMD) of the lasers. It was discussed that current crowding, localized high temperature, and large temperature gradient contributed to the fast indium solder electromigration. It was observed that some bright pattern structures appeared on the front facet of the indium solder bonded lasers after the devices failed and the bright patterns grew and spread upon further testing. Failure analysis showed that the bright pattern structure apparent on the front facet was due to crystallization of the TiOx material of the front facet coating as a result of overheating during lifetime testing. It was concluded that indium solder is not suitable for high power laser applications due to electromigration at high current densities and high temperatures.

  9. Case study of lean manufacturing application in a die casting manufacturing company

    NASA Astrophysics Data System (ADS)

    Ching, Ng Tan; Hoe, Clarence Chan Kok; Hong, Tang Sai; Ghobakhloo, Morteza; Pin, Chen Kah

    2015-05-01

    The case study of lean manufacturing aims to study the application of lean manufacturing in a die casting manufacturing company located in Pulau Penang, Malaysia. This case study describes mainly about the important concepts and applications of lean manufacturing which could gradually help the company in increasing the profit by studying and analyzing their current manufacturing process and company culture. Many approaches of lean manufacturing are studied in this project which includes: 5S housekeeping, Kaizen, and Takt Time. Besides, the lean tools mentioned, quality tool such as the House of Quality is being used as an analysis tool to continuously improve the product quality. In short, the existing lean culture in the company is studied and analyzed, with recommendations written at the end of this paper.

  10. Frictional interactions in forming processes: New studies with transparent sapphire strip-drawing dies

    NASA Astrophysics Data System (ADS)

    Rao, R. S.; Lu, C. Y.; Wright, P. K.; Devenpeck, M. L.; Richmond, O.; Appleby, E. J.

    1982-05-01

    This research is concerned with the frictional interactions at the toolwork interfaces in the machining and strip-drawing processes. A novel feature is that transparent sapphire (single crystal Al2O3) is being used as the tool and die material. This allows the tribological features of the interface to be directly observed and recorded on movie-film. These qualitative studies provide information on the role of lubricants. In addition, techniques are being developed to quantify the velocity gradient along the interface. For example, in the drawing work it has been found that tracer markings (e.g. dye-spots), applied to the undrawn strip, remain intact during drawing and can be tracked along the sapphire/strip interface. Such data will be used as input to a finite-element, elasto-plastic-workhardening model of the deformation process. The latter can compute strip deformation characteristics, drawing forces and local coefficients of friction at the interface. Introductory results will be presented in this paper, obtained from drawing tin-plated mild steel with sapphire and cemented carbide dies. Drawing loads and die-separating forces will be presented and movie-films of the action of tracer markings at the interface shown. In order to demonstrate how this data can be used in an analysis of a large strain deformation process with friction, initial results from running the FIPDEF elasto-plastic code will be discussed. From a commercial viewpoint research on strip-drawing is of special interest to the can-making industry. From a physical viewpoint stripdrawing is of particular interest because it is a symmetrical, plane strain deformation and, in comparison with other metal processing operations, it is more readily modeled. However, until now the elasto-plastic codes that have been developed to predictively model drawing have had limitations: the most notable being that of quantifying the friction conditions at the die-work interface. Hence the specification of the

  11. Studying the Nazi Period: Some Considerations.

    ERIC Educational Resources Information Center

    Molnar, Alex; And Others

    1984-01-01

    Students should be taught how to make well-reasoned and analytic judgments about the Nazis. The process of arriving at judgments about the Nazi period should be characterized by a factual knowledge of the Nazi era within a general historical knowledge of the period, sympathy, and an open mind. (RM)

  12. Dynamics of nutritional status in dying patients with acute cerebral infarction in central China: a preliminary study.

    PubMed

    Zhang, Hong; Shu, Yi; Zhang, Junjian; Tong, Etang

    2011-06-01

    Stroke is the number one cause of death in China. Although the effective management has reduced the mortality and lengthened survival, little attention has been paid to nutritional issues in patients with stroke in China. This study aimed to assess the premorbid nutrition status in dying patients with acute cerebral infarction. In this study, a total of 185 acute ischemic stroke patients dying within 30 days were recruited from medical records. Characteristics of dying patients were assessed on admission, and serum biochemical parameters including serum total protein, serum albumin, and serum prealbumin were measured within 24 hours after stroke onset and every week routinely. Among 185 ischemic stroke patients, 86 dying patients experienced their first-ever acute cerebral infarction, while 99 dying patients were experiencing a recurrent cerebral infarction. The prevalence of dysphagia, post-stroke pneumonia, and gastrointestinal hemorrhage in recurrent stroke groups were higher than those in the first-ever stroke group (P<0.01). There were gradually declines in serum total protein, serum albumin, and serum prealbumin in dying patients from admission to death, especially in the recurrent ischemic stroke group, as compared to their normal range. The sensitive sequence of serum nutritional index for dying patients with ischemic infarction was: serum prealbumin>serum albumin>serum total protein. This study showed that hypoproteinemia and undernutrition were serious in dying patients with acute ischemic stroke, especially in patients with recurrent ischemic stroke. This study also confirmed that serum prealbumin is more sensitive than serum albumin to assess nutritional status. The strategies to improve malnutrition in stroke patients are urgently needed in China.

  13. Vigilant attentiveness in families observing deterioration in the dying intensive care patient: A secondary analysis study.

    PubMed

    Coombs, Maureen; Tang, Juliana; Long-Sutehall, Tracy

    2016-04-01

    Family support in intensive care is often focussed on what information is communicated to families. This is particularly important during treatment withdrawal and end of life care. However, this positions families as passive receivers of information. Less is known about what bereaved family members actually observe at end of life and how this is interpreted. Secondary analysis study was conducted in order to explore the concept of vigilant attentiveness in family members of adult patients dying in intensive care. Secondary analysis of eight interviews sorted from two primary data sets containing 19 interviews with 25 bereaved family members from two intensive care units in England was undertaken. Directed content analysis techniques were adopted. Families are observant for physiological deterioration by watching for changes in cardiac monitors as well as paying attention to how their relative looks and sounds. Changes in treatment/interventions were also perceived to indicate deterioration. Families are vigilant and attentive to deterioration, implying that families are active participants in information gathering. By clarifying what families notice, or do not notice during the dying trajectory in ICU, health care professionals can tailor information, helping to prepare families for the death of their relative. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. [The meaning of dying with dignity from caregivers perspective: a phenomenological study].

    PubMed

    Ibáñez-Masero, Olivia; Ortega-Galán, Ángela M; Carmona-Rega, M Inés; Ruiz-Fernández, M Dolores; Cabrera-Troya, José; García-Cisneros, Rogelio; Medina, Fernando Relinque

    To explore the meaning of dying with dignity from the perspective of the direct witnesses who have accompanied this process in dying people from Andalusia. Phenomenological study conducted in different centres, which including analysing the transcriptions of the dialogues from discussion groups with 40 participants in five provinces in Southern Spain. The data was analysed using the Van Manen proposal and Atlas Ti 7.0 program was applied as a software tool. Being in the company of loved ones is noted as a key element in the perception of a dignified death. The following elements, according to a priority order, were also pointed out: relief of suffering, a good professional care, decision making ability, and the opportunity to consider their spiritual dimension. Achievement of their Living Wills is hardly mentioned. The essential elements defined in the Death with Dignity Law, 2/2010 are confirmed as being true (without suffering, with company, respecting living wills, having possibilities of the farewell, and the transcendental meaning of the death process). Caregivers, at the end of life, give priority to psychological aspects, underlying the need of company, a farewell of the loved ones, and a good professional care on the physical aspects. The promotion of the dignified Death Law and Living Wills are still being developed. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

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

    PubMed

    Karlsson, Marit; Milberg, Anna; Strang, Peter

    2012-05-01

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

  16. An experimental study on the effect of die geometry on swell and sag in the parison extrusion stage

    NASA Astrophysics Data System (ADS)

    Pecora, L.; Diraddo, R. W.

    1993-01-01

    Extrusion blow molding is the process of choice for production of many hollow parts. The process involves extrusion of a molten parison and inflation of the parison into the final part, whereupon the part is cooled and ejected. The ability to predict parison behavior is important as the parison dimensions govern the shape and thickness distribution of the final product. The effect of die geometry on parison swell and sag was studied in experiments employing three diverging dies of 3.5 cm diameter. Three mandrel angles were studied, being 25, 30, and 40 deg from the vertical. For each die angle, six gaps ranging from 0.3 to 2.0 mm were studied. The material used was a blow molding high density polyethylene grade. Preliminary results were obtained showing that the sag increases and the swell decreases as the die gap is increased. Swell was found to increase as die angle increased. The parison swell depends directly on the shear and extensional components in the die. The extensional component has a stronger effect than shear for a given level of stress.

  17. Characteristics of people dying by suicide after job loss, financial difficulties and other economic stressors during a period of recession (2010-2011): A review of coroners׳ records.

    PubMed

    Coope, Caroline; Donovan, Jenny; Wilson, Caroline; Barnes, Maria; Metcalfe, Chris; Hollingworth, William; Kapur, Nav; Hawton, Keith; Gunnell, David

    2015-09-01

    Suicide rates increase during periods of economic recession, but little is known about the characteristics of people whose deaths are related to recession, the timing of risk in relation to job loss, the nature of financial stresses and the sources of help individuals used. We extracted information on social and economic circumstances, mental health and help-seeking from the coroners׳ records of 286 people who died by suicide in 2010 and 2011 in four areas of England. We graded each death on a 5-point scale of 'recession-relatedness', measuring the extent to which recession, employment and financial problems contributed to the death. Financial and employment-related issues contributed substantially to 38 (13%) of the deaths and were thought to be the key contributing factor in 11 (4%). Individuals whose deaths were thought to be related to the recession were less likely to have previously self-harmed but were more likely to be employed (61% vs. 43%), have financial difficulties (76% vs. 23%) and financial dependents (55% vs. 23%). Amongst the subset of 11 people where financial/employment issues were the key contributory factor, only two (18%) had ever had contact with psychiatric services. Details on finances and employment were not systematically recorded by coroners. We found richer information was usually available for people who were living with other people. Financial difficulties, little past psychiatric history, low levels of service contact and having financial dependents were more common in 'recession-related' deaths. This suggests that interventions to prevent recession-related rises in suicide should be focused on non-clinical agencies and initiatives. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  18. 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.

  19. Study on Carbide in Forged and Annealed H13 Hot Work Die Steel

    NASA Astrophysics Data System (ADS)

    Li, Ji; Li, Jing; Wang, Liangliang; Li, Longfei

    2015-10-01

    The present work studied the carbides in forged and annealed H13 hot work die steel. The carbides were examined by scanning electron microscopy (SEM), energy dispersive spectrometer (EDS) and X-ray diffraction (XRD) and analyzed with quantitative chemical analysis method. The carbide types, qualities and compositions in dependence on temperatures were thermodynamically calculated by Thermo-Calc software and compared with the experimental results. In the final, methods for carbide improvement were discussed. The results are as follows. The primary carbides and the carbide segregation are improved after the hot-forging operation. The carbides in the hot-forged and annealed H13 steel are M7C3, M6(C, N) and M(C, N) which is accordance with the calculated results. Trace Mg added to the H13 steel leads to an increase of primary carbide nucleation and a decrease of primary carbide size.

  20. 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.

  1. Suicide assisted by right-to-die associations: a population based cohort study.

    PubMed

    Steck, Nicole; Junker, Christoph; Maessen, Maud; Reisch, Thomas; Zwahlen, Marcel; Egger, Matthias

    2014-04-01

    In Switzerland, assisted suicide is legal but there is concern that vulnerable or disadvantaged groups are more likely to die in this way than other people. We examined socio-economic factors associated with assisted suicide. We linked the suicides assisted by right-to-die associations during 2003-08 to a census-based longitudinal study of the Swiss population. We used Cox and logistic regression models to examine associations with gender, age, marital status, education, religion, type of household, urbanization, neighbourhood socio-economic position and other variables. Separate analyses were done for younger (25 to 64 years) and older (65 to 94 years) people. Analyses were based on 5 004 403 Swiss residents and 1301 assisted suicides (439 in the younger and 862 in the older group). In 1093 (84.0%) assisted suicides, an underlying cause was recorded; cancer was the most common cause (508, 46.5%). In both age groups, assisted suicide was more likely in women than in men, those living alone compared with those living with others and in those with no religious affiliation compared with Protestants or Catholics. The rate was also higher in more educated people, in urban compared with rural areas and in neighbourhoods of higher socio-economic position. In older people, assisted suicide was more likely in the divorced compared with the married; in younger people, having children was associated with a lower rate. Assisted suicide in Switzerland was associated with female gender and situations that may indicate greater vulnerability such as living alone or being divorced, but also with higher education and higher socio-economic position.

  2. Caring for people dying in acute hospitals: A mixed-methods study to examine relative's perceptions of care.

    PubMed

    Clark, Katherine; Cain, Jess; Campbell, Lyn; Byfieldt, Naomi

    2015-04-01

    Improving the care provided for people dying in acute healthcare facilities has been identified as a priority for Australian healthcare. Previous observations support the idea that quality care improves outcomes for the dying person as well as for their relatives. To improve care it is essential that there be a clear understanding of which issues require attention. The aim of our project was to improve the understanding of the experiences of family members whose relatives had died on an acute medical ward. A mixed-methods approach was adopted for our study. With the approval of the human ethics committee, relatives were approached within three months of the death of their family member and invited to participate in an interview based on a quality-of-dying-and-death (QoDD) tool. Of the 50 families approached, 10 agreed to be interviewed. When they were asked to reflect on the experiences of the dying person, the issues that they articulated most strongly related to the need to have time before death to address issues and spend time with important others. With regards to the needs of the dying person's relatives, people articulated strongly that they needed information, support, and evidence of good symptom control. The provision of support post-death was also poignantly highlighted. This study supports observations made in other clinical areas that have identified that timely communication, good symptom control, and ongoing support for both the dying person and their family has important ramifications. Articulating such details is an important part of understanding which aspects of care require attention.

  3. Changing place of death in children who died after discharge from paediatric intensive care units: A national, data linkage study.

    PubMed

    Fraser, Lorna K; Fleming, Sarah; Parslow, Roger

    2017-05-01

    Although child mortality is decreasing, more than half of all deaths in childhood occur in children with a life-limiting condition whose death may be expected. To assess trends in place of death and identify characteristics of children who died in the community after discharge from paediatric intensive care unit. National data linkage study. All children resident in England and Wales when admitted to a paediatric intensive care unit in the United Kingdom (1 January 2004 and 31 December 2014) were identified in the Paediatric Intensive Care Audit Network dataset. Linkage to death certificate data was available up to the end of 2014. Place of death was categorised as hospital (hospital or paediatric intensive care unit) or community (hospice, home or other) for multivariable logistic modelling. The cohort consisted of 110,328 individuals. In all, 7709 deaths occurred after first discharge from paediatric intensive care unit. Among children dying, the percentage in-hospital at the time of death decreased from 83.8% in 2004 to 68.1% in 2014; 852 (0.8%) of children were discharged to palliative care. Children discharged to palliative care were eight times more likely to die in the community than children who died and had not been discharged to palliative care (odds ratio = 8.06 (95% confidence interval = 6.50-10.01)). The proportion of children dying in hospital is decreasing, but a large proportion of children dying after discharge from paediatric intensive care unit continue to die in hospital. The involvement of palliative care at the point of discharge has the potential to offer choice around place of care and death for these children and families.

  4. Factor structure of the multidimensional orientation toward dying and death inventory among Hong Kong college students: a preliminary study.

    PubMed

    Wittkowski, Joachim; Ho, Samuel M Y; Chan, Wallace C H

    2011-01-01

    This study examines the factor structures of the Chinese version of the Multidimensional Orientation Toward Dying and Death Inventory (MODDI-F/ chin), originally established in German language, in a sample of Hong Kong college students (n = 256). Both confirmatory factor analysis and exploratory factor analysis were performed to examine the factor structures of the MODDI-F/ chin. The results showed that, identical to the German version, the MODDI-F/chin consisted of a 5-factor Fear domain and a 3-factor Acceptance domain. The fear of another person's dying was the weakest of the four factors in the Hong Kong sample but represented the first and strongest factor in the German sample of the original study. Although preliminary and not representative of mainland China, our results show that the factor structure of attitudes toward dying and death that had been established empirically with German people can be replicated with Chinese students of Hong Kong.

  5. Studies of Long Period Eclipsing Binaries

    NASA Astrophysics Data System (ADS)

    Ratajczak, M.; Hełminiak, K. G.; Konacki, M.

    2015-07-01

    The survey of long period eclipsing binaries from the All Sky Automated Survey (ASAS) catalog aims at searching for and characterizing subgiants and red giants in double-lined detached binary systems. Absolute physical and orbital parameters are presented based on radial velocities from high-quality optical spectra obtained with the following telescope/instrument combinations: 8.2 m Subaru/HDS, ESO 3.6 m/HARPS, 1.9 m Radcliffe/GIRAFFE, CTIO 1.5 m/CHIRON, and 1.2 m Euler/CORALIE. Photometric data from ASAS, SuperWASP, and the Solaris Project were also used. We discuss the derived uncertainties for the individual masses and radii of the components (better than 3% for several systems), as well as results from the spectral analysis performed for components of systems whose spectra we disentangled.

  6. Perceptions of speech-pathology and audiology students concerning death and dying: a preliminary study.

    PubMed

    Rivers, Kenyatta O; Perkins, Rosalie A; Carson, Cecyle P

    2009-01-01

    Formal training in dealing with death and dying issues is not a standard content area in communication sciences and disorders programmes' curricula. At the same time, it cannot be presumed that pre-professional students' personal background equips them to deal with these issues. To investigate the perceptions of pre-professional speech-language pathology and audiology students' need for formal training in death and dying issues. Participants were 230 undergraduate and graduate students enrolled in communication sciences and disorders courses in a southern, metropolitan university, in the USA. A questionnaire developed by the researchers was given. Post-hoc analyses were conducted. Results indicated that participants desired training in the area of death and dying before entering the professional world, even though they rated themselves to be fairly knowledgeable about the topic. Preferred methods for acquiring knowledge about death and dying were personal and professional experiences, followed by consulting professional resources, classroom instruction, and talking to professionals who are familiar with death and dying. Education in death and dying is needed by pre-professional, speech-language pathology and audiology students who appear to be at risk for professional obstacles and emotional trauma from the death of their patients.

  7. The Stigma against Dying and Suicidal Patients: A Replication of Richard Kalish's Study Twenty-Five Years Later.

    ERIC Educational Resources Information Center

    Lester, David

    1993-01-01

    Study of prejudice directed toward deviant and psychiatric groups and toward religious and ethnic groups involving 44 college student subjects replicated results of 25-year-old study. Deviant and psychiatric groups, including people dying from cancer and suicide attempters, received more prejudice than did religious and ethnic groups. Extraversion…

  8. Antiretroviral therapy status among people who died of AIDS-related causes from 2009 to 2013 in Brazil: a population-based study.

    PubMed

    de Freitas, Marcelo Araújo; Miranda, Angélica Espinosa; Pascom, Ana Roberta Pati; de Oliveira, Silvano Barbosa; Mesquita, Fabio; Ford, Nathan

    2016-11-01

    To describe the antiretroviral therapy status of people living with HIV (PLHIV) who died of AIDS-related causes between 2009 and 2013. We conducted a cross-sectional, population-based study. Data were obtained by linking the mortality information system and the national ART dispensing database. Trends were modelled using linear regression analysis. A total of 61 425 AIDS-related deaths were registered in Brazil between 2009 and 2013. Median age at death was 41 years (IQR: 33-49), and 65.7% (40 337) of deaths were among men; 47.2% (29 004) of PLHIV who died during the study period had never started treatment, 7.0% (4274) had discontinued it, 15.9% (9775) were on ART for 6 months or less and 29.9% (18 372) were on ART for more than 6 months. Only 1.3% of PLHIV were on third-line ARV regimens when they died. AIDS-related mortality remains a challenge even in a context of sustained universal access to antiretroviral treatment due to failure of service provision, not to therapy failure. Robust health policies closing gaps in the HIV continuum of care are crucial to further reduce mortality. © 2016 John Wiley & Sons Ltd.

  9. [The right to die with dignity in an acute-care hospital: a qualitative study].

    PubMed

    Sepúlveda-Sánchez, Juana María; Morales-Asencio, Jose Miguel; Morales-Gil, Isabel María; Canca-Sánchez, José Carlos; Crespillo-García, Eva; Timonet-Andreu, Eva María

    2014-01-01

    To examine the perceptions and beliefs of doctors and nurses, and the barriers and facilitators they must address as regards the right to die with dignity in an acute-care hospital, and to consider the applicability of the provisions of Law 2/2010 of 8 April in this respect. A qualitative descriptive study, based on the focus group technique, using discourse analysis of the views of doctors and nurses responsible for the health care of terminal cancer and non-cancer patients in an acute-care hospital. The results obtained show that there are diverse obstacles to assure the rights of terminal patients, and to ensure the proper performance of their duties by healthcare professionals and institutions. The nature and impact of these difficulties depend on the characteristics of the patients and their families, the health workers involved, the organisation of health care, and cultural factors. The study highlights the need to improve the process of communication with patients and their families, to facilitate shared decision making and to establish measures to clarify issues such as palliative sedation and treatment limitation. It is necessary to improve the applicability of the law on living wills and dignified death in non-cancer specialist areas. Further training is needed regarding ethical, spiritual and anthropological aspects of care in these situations. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  10. Modeling the Mechanical Performance of Die Casting Dies

    SciTech Connect

    R. Allen Miller

    2004-02-27

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

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

    PubMed Central

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

    2007-01-01

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

  12. The wish to die among palliative home care clients in Ontario, Canada: A cross-sectional study.

    PubMed

    Freeman, Shannon; Smith, Trevor Frise; Neufeld, Eva; Fisher, Kathy; Ebihara, Satoru

    2016-02-29

    In the pursuit to provide the highest quality of person centered palliative care, client preferences, needs, and wishes surrounding end of life should be used to inform the plan of care. During a clinical assessment for care services, clients may voluntarily express a 'wish to die' either directly to the clinician or it may be indirectly reported second-hand to the clinician through an informal caregiver or family member. This is the first study using data gathered from the interRAI Palliative Care Assessment instrument (interRAI PC) to examine socio-demographic, clinical, and psycho-social factors of palliative home care clients with the voluntary expression of a 'wish to die now'. Factors associated with the risk for depression within this group were also identified. Awareness and understanding of clients who express the 'wish to die' is needed to better tailor a person-centered approach to end-of-life care. This cross-sectional study included assessment records gathered from 4,840 palliative home care clients collected as part of pilot implementation of the interRAI PC assessment instrument in Ontario, Canada from 2006 through 2011. During the clinical assessment, 308 palliative home care clients (6.7%) had voluntarily expressed a 'wish to die now'. Independent factors emerging from multivariate logistic regression analyses predicting the expression of a 'wish to die' included not being married/widowed, a shorter estimated prognosis, depressive symptoms, functional impairment, too much sleep (excessive amount), feeling completion regarding financial/legal matters, and struggling with the meaning of life. Among persons who expressed a 'wish to die now', those who exhibited depressive symptoms (23.8%, n = 64) were also more likely to exhibit cognitive impairment, have decline in cognition in the last 90 days, exhibit weight loss, have informal caregivers exhibiting distress, 'not have a consistent positive outlook on life' and report 'struggling with the

  13. 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.

  14. Chinese oncology nurses' experience on caring for dying patients who are on their final days: a qualitative study.

    PubMed

    Zheng, Rui-Shuang; Guo, Qiao-Hong; Dong, Feng-Qi; Owens, R Glynn

    2015-01-01

    Caring for dying patients is stressful but an unavoidable responsibility of nurses. However, little is known about Chinese oncology nurses' experience of caring for dying cancer patients who are in their final days. To elucidate Chinese oncology nurses' experience of caring for dying cancer patients. This is a qualitative descriptive study, semi-structured interviews was utilized to explore views of purposive sample of 28 nurses who have been taking care of terminally ill patients in a cancer hospital in Tianjin, mainland China. Transcripts were entered into NVivo. Qualitative thematic analysis was used to analyze the data for significant statements and phrases that in turn were organized into themes and sub-themes. Five themes were identified in the data: end-of-life care for dying cancer patients, end-of-life care for family members, cultural sensitivity and communication, moral distress and self-limitations, self-reflection and benefit-finding. Death is a taboo in traditional Chinese culture. This increases the difficulty of effective communication between nurses, patients and families. Although nurses suffered emotional distress when caring for dying cancer patients, these experiences helped them to reflect on the meaning of death and life, and positively influenced their daily lives, attitudes and behaviors toward caring for the dying. Chinese nurses had strong willingness to offer quality end-of-life care to patients and families, however, they suffered moral distress because of self-limitation, lack of knowledge and confidence and inexperience in psychological care. End-of-life care in China reflects and has been influenced by the traditional Chinese culture. Chinese nurses reported suffering but also benefiting from their experiences. End-of-life cancer care training is needed by Chinese oncology nurses, especially for those who are younger and less experienced. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Goals Set in the Land of the Living/Dying: A Longitudinal Study of Patients Living with Advanced Cancer

    ERIC Educational Resources Information Center

    Nissim, Rinat; Rennie, David; Fleming, Stephen; Hales, Sarah; Gagliese, Lucia; Rodin, Gary

    2012-01-01

    A longitudinal qualitative research study was undertaken to provide an understanding of a prolonged experience of advanced cancer, as seen through the eyes of dying individuals. Using a variant of the grounded theory method, the authors theoretically sampled, from outpatient clinics in a large comprehensive cancer treatment center, 27 patients…

  16. Factor Structure of the Multidimensional Orientation toward Dying and Death Inventory among Hong Kong College Students: A Preliminary Study

    ERIC Educational Resources Information Center

    Wittkowski, Joachim; Ho, Samuel M. Y.; Chan, Wallace C. H.

    2011-01-01

    This study examines the factor structures of the Chinese version of the Multidimensional Orientation Toward Dying and Death Inventory (MODDI-F/chin), originally established in German language, in a sample of Hong Kong college students (n = 256). Both confirmatory factor analysis and exploratory factor analysis were performed to examine the factor…

  17. Goals Set in the Land of the Living/Dying: A Longitudinal Study of Patients Living with Advanced Cancer

    ERIC Educational Resources Information Center

    Nissim, Rinat; Rennie, David; Fleming, Stephen; Hales, Sarah; Gagliese, Lucia; Rodin, Gary

    2012-01-01

    A longitudinal qualitative research study was undertaken to provide an understanding of a prolonged experience of advanced cancer, as seen through the eyes of dying individuals. Using a variant of the grounded theory method, the authors theoretically sampled, from outpatient clinics in a large comprehensive cancer treatment center, 27 patients…

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

    PubMed Central

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

    2010-01-01

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

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

    PubMed

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

    2010-04-01

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

  20. A Periodical Use Study at Children's Hospital of Michigan

    PubMed Central

    Smith, Joan M. B.

    1970-01-01

    A periodical use study conducted in the medical library of a pediatric teaching hospital showed that the three kinds of periodical use, circulation, reading room use, and interlibrary loan follow similar patterns within the same library. Periodicals published in the most recent five years are the most used; less than 5 percent of periodicals used were over fifteen years old. Data from the study were used in making administrative and planning decisions for the library in which it was conducted. PMID:5411707

  1. Perceptions of Speech-Pathology and Audiology Students Concerning Death and Dying: A Preliminary Study

    ERIC Educational Resources Information Center

    Rivers, Kenyatta O.; Perkins, Rosalie A.; Carson, Cecyle P.

    2009-01-01

    Background: Formal training in dealing with death and dying issues is not a standard content area in communication sciences and disorders programmes' curricula. At the same time, it cannot be presumed that pre-professional students' personal background equips them to deal with these issues. Aim: To investigate the perceptions of pre-professional…

  2. Signs of Imminent Dying and Change in Symptom Intensity During Pharmacological Treatment in Dying Nursing Home Patients: A Prospective Trajectory Study.

    PubMed

    Sandvik, Reidun K; Selbaek, Geir; Bergh, Sverre; Aarsland, Dag; Husebo, Bettina S

    2016-09-01

    To investigate whether it is possible to determine signs of imminent dying and change in pain and symptom intensity during pharmacological treatment in nursing home patients, from day perceived as dying and to day of death. Prospective, longitudinal trajectory trial. Forty-seven nursing homes within 35 municipalities of Norway. A total of 691 nursing home patients were followed during the first year after admission and 152 were assessed carefully in their last days of life. Time between admission and day of death, and symptom severity by Edmonton symptom assessment system (ESAS), pain (mobilization-observation-behavior-intensity-dementia-2), level of dementia (clinical dementia rating scale), physical function (Karnofsky performance scale), and activities of daily living (physical self-maintenance scale). Twenty-five percent died during the first year after admission. Increased fatigue (logistic regression, odds ratio [OR] 1.8, P = .009) and poor appetite (OR 1.2, P = .005) were significantly associated with being able to identify the day a person was imminently dying, which was possible in 61% of the dying (n = 82). On that day, the administration of opioids, midazolam, and anticholinergics increased significantly (P < .001), and was associated with amelioration of symptoms, such as pain (mixed-models linear regression, 60% vs 46%, P < .001), anxiety (44% vs 31%, P < .001), and depression (33% vs 15%, P < .001). However, most symptoms were still prevalent at day of death, and moderate to severe dyspnea and death rattle increased from 44% to 53% (P = .040) and 8% to 19% (P < .001), respectively. Respiratory symptoms were not associated with opioids or anticholinergics. Pharmacological treatment ameliorated distressing symptoms in dying nursing home patients; however, most symptoms, including pain and dyspnea, were still common at day of death. Results emphasize critical needs for better implementation of guidelines and staff education. Clinical

  3. ULS Joint Committee to Study Library Periodical Services. Final Report.

    ERIC Educational Resources Information Center

    Hirshon, Arnold; And Others

    Developed in response to issues raised about the circulation of bound periodicals, the cost of photocopies, and the condition of the photocopiers, this report of the Joint Committee to Study Library Periodical Services at the Virginia Commonwealth University libraries recommends goals for periodicals services for both campuses of the university.…

  4. Doctors' and nurses' views and experience of transferring patients from critical care home to die: a qualitative exploratory study.

    PubMed

    Coombs, Maureen; Long-Sutehall, Tracy; Darlington, Anne-Sophie; Richardson, Alison

    2015-04-01

    Dying patients would prefer to die at home, and therefore a goal of end-of-life care is to offer choice regarding where patients die. However, whether it is feasible to offer this option to patients within critical care units and whether teams are willing to consider this option has gained limited exploration internationally. To examine current experiences of, practices in and views towards transferring patients in critical care settings home to die. Exploratory two-stage qualitative study Six focus groups were held with doctors and nurses from four intensive care units across two large hospital sites in England, general practitioners and community nurses from one community service in the south of England and members of a Patient and Public Forum. A further 15 nurses and 6 consultants from critical care units across the United Kingdom participated in follow-on telephone interviews. The practice of transferring critically ill patients home to die is a rare event in the United Kingdom, despite the positive view of health care professionals. Challenges to service provision include patient care needs, uncertain time to death and the view that transfer to community services is a complex, highly time-dependent undertaking. There are evidenced individual and policy drivers promoting high-quality care for all adults approaching the end of life encompassing preferred place of death. While there is evidence of this choice being honoured and delivered for some of the critical care population, it remains debatable whether this will become a conventional practice in end of life in this setting. © The Author(s) 2014.

  5. Die Soldering in Aluminium Die Casting

    SciTech Connect

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

    2000-03-15

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

  6. An experimental study of die attach polymer bleedout in ceramic packages

    NASA Astrophysics Data System (ADS)

    Marks, Michael R.; Thompson, Joyce A.; Gopalakrishnan, R.

    1994-11-01

    The phenomenon of die attach polymer bleedout in gold plated ceramic packages poses a serious problem to the wire bonding process. Bleedout is basically a surface wetting process between the liquid die attach polymer and the gold plating. Two methods may be employed to eliminate bleedout: the surface energy reduction of the gold plating or the improvement in the cohesiveness of the polymer die attach. The surface effects of vacuum baking at 200 C and 0.1 mbar, which is a widely used method to reduce the plating surface energy, were investigated. It was found that vacuum baking for 4 h was sufficient to eliminate bleedout through the formation of a nickel oxide film on the plating surface. However, the oxide film can detrimentally affect wire bonding quality and, as such, vacuum baking is not recommended. An alternative method to eliminate bleedout is by increasing the cohesiveness of the polymer matrix. This can be achieved by increasing the intermolecular attractive energy through the presence of functional groups with high dipole moments in high concentrations. Phenol-cured epoxy, polyimide and polycyanurate were found to have good bleedout resistance, presumably owing to the high dipole moments of epoxide and hydroxyl in phenol-cured epoxy, carbonyl and hydroxyl in polyimide, and nitrile and carbonyl in polycyanurate. The use of such polymers makes vacuum baking or other surface treatment of the gold plating unnecessary.

  7. Home to die from the intensive care unit: A qualitative descriptive study of the family's experience.

    PubMed

    Hutchinson, Amy L; Van Wissen, Kim A

    2017-09-12

    Many people would choose to die at home, and this can be an option for intensive care patients. However, there is limited exploration of the impact on the family. To gain insight into family members' experiences when an adult intensive care unit patient is taken home to die. Methodology is qualitative description, utilising purposeful sampling, unstructured interviews and thematic analysis. Four participants, from two different families were interviewed. The setting was a tertiary level Intensive Care Unit in New Zealand. The experience was described as a kaleidoscope of events with two main themes: 'value' family member's found in the patient going home, and their experience of the 'process'. 'Value' subthemes: going home being the patient's own decision, home as an end-of-life environment, and the patient's positive response to being at home. 'Process' subthemes: care and support received, stress of a family member being in intensive care, feeling that everything happened quickly, and concerns and uncertainties. Going home to die from the intensive care unit can be a positive but challenging experience for the family. Full collaboration between the patient, family and staff is essential, to ensure the family are appropriately supported. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Dying comfortably in very old age with or without dementia in different care settings - a representative "older old" population study.

    PubMed

    Fleming, Jane; Calloway, Rowan; Perrels, Anouk; Farquhar, Morag; Barclay, Stephen; Brayne, Carol

    2017-10-05

    Comfort is frequently ranked important for a good death. Although rising numbers of people are dying in very old age, many with dementia, little is known about symptom control for "older old" people or whether care in different settings enables them to die comfortably. This study aims to examine, in a population-representative sample, associations between factors potentially related to reported comfort during very old people's final illness: physical and cognitive disability, place of care and transitions in their final illness, and place of death. Retrospective analyses linked three data sources for n = 180 deceased study participants (68% women) aged 79-107 in a representative population-based UK study, the Cambridge City over-75s Cohort (CC75C): i) prospective in-vivo dementia diagnoses and cognitive assessments, ii) certified place of death records, iii) data from interviews with relatives/close carers including symptoms and "How comfortable was he/she in his/her final illness?" In the last year of life 83% were disabled in basic activities, 37% had moderate/severe dementia and 45% minimal/mild dementia or cognitive impairment. Regardless of dementia/cognitive status, three-quarters died following a final illness lasting a week or longer. 37%, 44%, 13% and 7% of the deceased were described as having been "very comfortable", "comfortable", "fairly comfortable" or "uncomfortable" respectively during their final illness, but reported symptoms were common: distress, pain, depression and delirium or confusion each affected 40-50%. For only 10% were no symptoms reported. There were ≥4-fold increased odds of dying comfortably associated with being in a care home during the final illness, dying in a care home, and with staying in place (dying at what death certificates record as "usual address"), whether home or care home, compared with hospital, but no significant association with disability or dementia/cognitive status, regardless of adjustment. These findings

  9. The relationship between soil geochemistry and die back of montane forests in Sri Lanka: a case study

    NASA Astrophysics Data System (ADS)

    Ranasinghe, P. N.; Dissanayake, C. B.; Samarasinghe, D. V. N.; Galappatti, R.

    2007-01-01

    Tropical montane forests of Sri Lanka form a unique ecosystem with more than 50% of endemic plant species. It has been noted that trees, belonging to different size and age classes of these forest, have been dying due to a yet unknown factor. This phenomenon was first observed in the Horton Plains National Park, which is a high plateau, composed of tropical montane forests. Later dying of forests were observed at several areas including Hakgala montane forest. Physical parameters trace nutrients as well as toxic element concentrations in soils, were studied in order to identify the possible geochemical factors behind the forest die back. Systematic soil sampling was carried out covering the entire Horton Plains National Park and random samples were collected from Hakgala montane forest. Samples were analyzed for available Fe, Mn, Zn, Cu, Ni, Cd, Al and Pb using standard colorimetric and atomic absorption spectrometric procedures. Physical parameters such as pH, moisture content, and conductivity of the samples were also measured. Among extractable micro-nutrients Cu and Zn, and Ni show no deficiency or excess levels. However, the recorded available high concentrations of Fe, Mn and Al can be toxic to certain montane plant species. Acidic moist soil of the area may enhance the toxic effects of these elements. Possible source of these elements should be the underground lithology of the area. According to the results obtained, there is a relationship between forest die back and high Pb concentrations. The same phenomenon was also observed in the Hakgala forest. The distribution pattern of Pb in the Horton Plains coincides well with the die back distribution pattern. The observed Pb values at Horton Plains and Hakgala are almost similar to values observed at Pannipitiya and Dombagaskanda locations, which are located close to main roads carrying heavy traffic. It is quite possible therefore, that Pb toxicity may be a significant factor behind the forest die back even

  10. The characteristics of patients who discontinue their dying process - an observational study at a single university hospital centre.

    PubMed

    Schulz, Christian; Schlieper, Daniel; Altreuther, Christiane; Schallenburger, Manuela; Fetz, Katharina; Schmitz, Andrea

    2015-12-07

    End-of-life integrated care plans are used as structuring tools for the care of the dying. A widely adopted example is the Liverpool Care Pathway for the Dying Patient (LCP). Recently, several concerns were raised about LCP care, such as a worry that diagnosis of dying might be leading to a self-fulfilling trajectory, including hastening of death. However, data on rates of discontinuation of LCP care are lacking. In an observational study, we therefore investigated the incidence, features and trajectory of patients who were discontinued from the LCP. We hypothesised that (1) it is common to discontinue patients from the LCP, (2) quality of life does not decrease for discontinued LCP patients, and (3) discontinued patients live longer than patients who remain within LCP care. All adult patients who were diagnosed as dying in a German university hospital specialized palliative care unit were included in 2013 and 2014. Actuarial estimation of survival prognostication tools and a number of quality of life indicators were used for data collection. Survival time was analysed using Kaplan-Meier estimates. Group differences in quality of life were tested using multivariate analysis of variance. 159 patients were included in a digital version of the LCP. 15 patients (9.4 %) were discontinued later. Quality of life did not decrease for discontinued patients during LCP care (p = 0.16). LCP discontinued patients lived significantly longer than the remaining LCP subgroup (difference of means 296 hours, 95 % confidence interval 105.5 to 451.5 hours; difference of survival function estimates p < 0.0001). When patients are diagnosed as dying, death is not the inevitable outcome of an end-of-life integrated care plan such as the LCP. Instead, it is common to discontinue the LCP care. Regular careful interprofessional assessments are important for identifying those patients who need to be discontinued from their end-of-life care plan. In this study, we found no evidence

  11. Study Program to Develop and Evaluate Die and Container Materials for the Growth of Silicon Ribbons

    NASA Technical Reports Server (NTRS)

    Ounby, P. D.; Yu, B. B.; Barsoum, M. W.

    1979-01-01

    The completion of a major hardware delivery milestone was accomplished with the delivery of three CNTD Si3N4 coated hot pressed Si3N4 crucibles. A limited characterization of the coating was performed at MRL prior to delivery. The coatings were fine grained alpha - Si3N4. It was determined that a two piece die design is required. The importance of the role of oxygen in influencing the attack of the CNTD materials by molten silicon was demonstrated. The stability is greatly enhanced by maintaining the oxygen partial pressure near or below the Si + O2 = SiO2 equilibrium.

  12. Old Habits Die Hard: A Nationwide Utilization Study of Short-Acting Nifedipine in Taiwan

    PubMed Central

    Chou, Chia-Lin; Chou, Chia-Yu; Hsu, Chia-Chen; Chou, Yueh-Ching; Chen, Tzeng-Ji; Chou, Li-Fang

    2014-01-01

    Background To investigate the nationwide trend of ambulatory prescriptions of short-acting nifedipine on a PRN (pro re nata) order over a fifteen-year period in Taiwan. Methods The systematic sampling claims datasets (0.2% sampling ratio) of ambulatory care visits within Taiwan's National Health Insurance from 1997 to 2011 were analyzed. The prescriptions of short-acting capsule-form nifedipine on a PRN order were stratified by the patient's age, the prescribing physician's specialty, and the setting of healthcare facility for each year. Results During the study period, 8,189,681 visits were analyzed. While the utilization rate of calcium channel blockers changed with time from 2.8% (13,767/489,636) in 1997 to 5.1% (31,349/614,719) in 2011, that of short-acting nifedipine were from 1.0% (n = 5,070) to 0.2% (n = 1,246). However, short-acting capsule-form nifedipine on a PRN order still existed (from 447 prescriptions in 1997 to 784 in 2011). More than one half of these PRN nifedipines were prescribed by the internists and to the elderly patients; almost four-fifths of PRN nifedipines were prescribed during non-emergent consultations. Conclusion The physicians in Taiwan still had the habit of prescribing short-acting nifedipines for PRN use. The reason for such practices and the impact on patients' health deserve attention. PMID:24637880

  13. Study of possible chaotic, quasi-periodic and periodic structures in quantum dusty plasma

    SciTech Connect

    Ghosh, Uday Narayan; Chatterjee, Prasanta; Roychoudhury, Rajkumar

    2014-11-15

    Existence of chaotic, quasi-periodic, and periodic structures of dust-ion acoustic waves is studied in quantum dusty plasmas through dynamical system approach. A system of coupled differential equations is derived from the fluid model and subsequently, variational matrix is obtained. The characteristic equation is obtained at the equilibrium point, and the behavior of nonlinear waves is studied numerically using Runge-Kutta method. The behavior of the dynamical system changes significantly when any of plasma parameters, such as the dust concentration parameter, temperature ratio, or the quantum diffraction parameter, is varied. The change of the characteristic of solution of the system is extensively studied. It is found that the system changes its behavior from chaotic pattern to limit cycle behavior.

  14. Study on objective functions for the slow shot phase in high-pressure die casting

    NASA Astrophysics Data System (ADS)

    Frings, Markus; Behr, Marek; Elgeti, Stefanie

    2016-10-01

    High-pressure die casting is an important process in the field of aluminum processing. Especially during the slow shot phase, the process parameters immensely influence the cast part quality. At the current state of the art, the appropriate process parameters are identified based on running-in trials and significant experience. To translate this experience into a mathematical framework is the aim of this work. The idea is to shift the running-in trials to the computer—now in the form of a numerical optimization. In view of the optimization, this paper presents a selection of objective functions. These are assessed with the respect to (1) their suitability as an overall quality measure of the casting process and (2) the extent to which they reflect the goals of the casting process.

  15. A Numerical and Experimental Study of Flow Behavior in High Pressure Die Casting

    NASA Astrophysics Data System (ADS)

    Saeedipour, Mahdi; Schneiderbauer, Simon; Pirker, Stefan; Bozorgi, Salar

    High pressure die casting (HPDC) is one of the most important and yet little known manufacturing methods especially during liquid metal injection and filling phase. During its application different problems can arise: on the one hand, wavy disintegration of the jet might result in cold shut defect in the final product, on the other hand a high degree of atomization may strongly increase the porosity defect. A numerical simulation using volume of fluid approach (VOF), is carried out to model the global spreading of liquid metal jet. The formation of droplets, which are usually smaller than the grid spacing in computational domain, is determined by a surface energy-based criterion. An Eulerian-Lagrangian framework is introduced to track and model the droplets after formation. Since liquid metal is hardly to access, we performed experiments based on water analogy to capture the flow regime changes and drop formation. The comparison between numerical results and experiments shows a very good agreement.

  16. Study program to develop and evaluate die and container materials for the growth of silicon ribbons

    NASA Technical Reports Server (NTRS)

    1978-01-01

    Initial sessile drop experiments on SiC, Si3N4 and A1N were conducted. Very promising results were achieved on both SiC and Si3N4 where minimal penetration of these CNTD coatings by molten silicon was observed. More detailed characterization of the CNTD microstructures was accomplished as well as X-ray characterization of the third and fourth candidate materials system sets (i.e. A1N and altered Si3N4). Polished sections of post sessile drop specimens were also prepared and evaluated. The techniques of full scale crucible hot pressing were developed and die grinding development was initiated. The apparatus for measurement of oxygen partial pressure was reconstructed and calibrated. The sessile drop temperature measurement procedure was calibrated for absorption by the pyrex view-port and additional Auger electron analysis was performed at the interface of molten silicon with CNTD Si3N4 and A1N.

  17. Study of Dynamic Characteristics for Hydraulic System on 300MN Die-forging Press

    NASA Astrophysics Data System (ADS)

    Chen, Guoqiang; Tan, Jianping

    2017-06-01

    The faults such as seal breakdown and pressure sensor damage occur in 300MN Die-forging press frequently. First, the fault phenomenon and harm of the hydraulic system was compiled statistics, the theoretical analysis of the hydraulic impact of hydraulic system are carried out based on the momentum theorem; Then, the co-simulation model of hydraulic system was established by AMESim and Simulink software and the correctness was verified. Finally, the dynamic characteristics of hydraulic system for the key working condition “forging stroke changing to mold collision” was analyzed, the influences rules of system parameters such as the leak gap of valve, diameter of water way pipeline, emulsion temperature and air contain act on hydraulic system are obtained. This conclusions have a theoretical guiding significance to the improvement and maintains of high pressure and large flow hydraulic system.

  18. A micro-mechanical evaluation of the effects of die hardener on die stone.

    PubMed

    He, Li-Hong; van Vuuren, Ludwig Jansen; Planitz, Nina; Swain, Michael V

    2010-08-01

    The purpose of this study was to investigate the properties of a die hardener penetrated layer and evaluate its protective effects on the surface of die stone. A commercial die hardener (PDQ die hardener, Whipmix corp., USA) was tested on a die stone (GC Fujirock EP die stone, GC Europe, Belgium) and a dental plaster (Dental Stone, United States Gypsum Company, USA). Nanoindentation and micro-scratch tests were performed on both coated and uncoated specimens. The scratch damage was observed by SEM and the penetration depth of die hardener was detected by the affiliated EDX. Upon drying, the die hardener penetrated into the die stone to a depth of 3-5 microm, and deposited a thin film on the surface of die stone. Although the die hardener penetrated layer did not show improved mechanical properties, the die hardener film on the surface did protect the specimens from abrasion damage.

  19. MECAR operation during the 6/95 study period

    SciTech Connect

    Capista, Dave; /Fermilab

    1995-01-01

    The MECAR system was scheduled to be used 36 hours during the study period. In practice the system was used a bit more since there is increasing pressure to switch completely over to MECAR. During this period of MECAR operation there were power supply studies, tune calibration, general tune-up with this system, and identification and some repair of bugs found in both the applications program and the MECAR operating system.

  20. Use of high-fidelity simulation to improve communication skills regarding death and dying: a qualitative study.

    PubMed

    Hawkins, A; Tredgett, K

    2016-12-01

    The objectives of this study were to explore medical students' experiences of communicating with patients and their carers about death and dying, and to assess whether using high-fidelity simulation improved students' confidence in discussing cardiopulmonary resuscitation. This qualitative study was carried out at a hospital in the south of England. Participants were 7 final-year medical students. Tutorials were developed using high-fidelity simulation to teach communication skills regarding discussion of cardiopulmonary resuscitation with patients and carers. Scenarios involved a simulated ward environment, a high-fidelity simulation mannequin and actor playing the role of a carer. Data were collected through joint interviews carried out by one researcher which were audio recorded and transcribed verbatim. The same researcher analysed the data using framework analysis. Students reported a lack of experience observing conversations with patients and carers about death and dying. They also reported a lack of opportunities to interact with dying patients during their training. Barriers reported by students included healthcare professionals' and patients' attitudes. Students reported a lack of confidence and preparedness to have consultations with patients and carers about death, dying and cardiopulmonary resuscitation as junior doctors. They perceived role-play scenarios observed by their peers to be stressful, and this detracted from the learning experience. Students reported that the high-fidelity simulation scenarios were more realistic than low-fidelity ('role-play') scenarios. This improved the learning gained from the sessions and improved confidence among some students. This study has suggested that high-fidelity simulation may be a useful adjunct for undergraduate communication skills training in palliative medicine. Further research is required to assess whether improvements in confidence described by students in this study translate to discernible

  1. Comparative evaluation of few physical properties of epoxy resin, resin-modified gypsum and conventional type IV gypsum die materials: an in vitro study.

    PubMed

    Gujjarlapudi, Manmohan Choudary; Reddy, S Varalakshmi; Madineni, Praveen Kumar; Ealla, Kranti Kiran Reddy; Nunna, Venkata Narayana; Manne, Sanjay Dutt

    2012-01-01

    To compare and evaluate few physical properties of epoxy resin, resin-modified gypsum and conventional type-IV gypsum die material. In the present study, dimensional accuracy, surface detail reproduction and transverse strength of three die materials like epoxy resin (Diemet-E), resin-modified gypsum (Synarock) and conventional type-IV gypsum (Ultrarock) are analyzed. For dimensional accuracy, master die (Bailey's die) is used and calibrations were made with digital microscope. For surface detail reproduction and transverse strength, rectangular stainless steel master die (Duke's die) was used and calibrations were made with Toolmaker's microscope and Instron universal testing machine respectively. One-way analysis of variance (ANOVA) was performed on the means and standard deviation for groups of each test. The results of the study showed statistically significant difference among these materials in dimensional accuracy, surface detail reproduction and transverse strength. Epoxy resin exhibited superiority in dimensional accuracy, surface detail reproduction and transverse strength and is nearest to the standards of accurate die material.

  2. Dying at home: a qualitative study of family carers’ views of support provided by GPs community staff

    PubMed Central

    Seamark, David; Blake, Susan; Brearley, Sarah G; Milligan, Christine; Thomas, Carol; Turner, Mary; Wang, Xu; Payne, Sheila

    2014-01-01

    Background Dying at home is the preference of many patients with life-limiting illness. This is often not achieved and a key factor is the availability of willing and able family carers. Aim To elicit family carers’ views about the community support that made death at home possible. Design and setting Qualitative study in East Devon, North Lancashire, and Cumbria. Method Participants were bereaved family carers who had provided care at the end of life for patients dying at home. Semi-structured interviews were conducted 6–24 months after the death. Results Fifty-nine bereaved family carers were interviewed (54% response rate; 69% female). Two-thirds of the patients died from cancer with median time of home care being 5 months and for non-cancer patients the median time for home care was 30 months. An overarching theme was of continuity of care that divided into personal, organisational, and informational continuity. Large numbers and changes in care staff diluted personal continuity and failure of the GPs to visit was viewed negatively. Family carers had low expectations of informational continuity, finding information often did not transfer between secondary and primary care and other care agencies. Organisational continuity when present provided comfort and reassurance, and a sense of control. Conclusion The requirement for continuity in delivering complex end-of-life care has long been acknowledged. Family carers in this study suggested that minimising the number of carers involved in care, increasing or ensuring personal continuity, and maximising the informational and organisational aspects of care could lead to a more positive experience. PMID:25452545

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

    PubMed

    Karlsson, Marit; Milberg, Anna; Strang, Peter

    2012-01-01

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

  4. Wege in die Zukunft

    NASA Astrophysics Data System (ADS)

    Kauermann, Göran; Mosler, Karl

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

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

    PubMed

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

    2014-07-01

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

  6. Experimental and Numerical Studies on the Formability of Materials in Hot Stamping and Cold Die Quenching Processes

    NASA Astrophysics Data System (ADS)

    Li, N.; Mohamed, M. S.; Cai, J.; Lin, J.; Balint, D.; Dean, T. A.

    2011-05-01

    Formability of steel and aluminium alloys in hot stamping and cold die quenching processes is studied in this research. Viscoplastic-damage constitutive equations are developed and determined from experimental data for the prediction of viscoplastic flow and ductility of the materials. The determined unified constitutive equations are then implemented into the commercial Finite Element code Abaqus/Explicit via a user defined subroutine, VUMAT. An FE process simulation model and numerical procedures are established for the modeling of hot stamping processes for a spherical part with a central hole. Different failure modes (failure takes place either near the central hole or in the mid span of the part) are obtained. To validate the simulation results, a test programme is developed, a test die set has been designed and manufactured, and tests have been carried out for the materials with different forming rates. It has been found that very close agreements between experimental and numerical process simulation results are obtained for the ranges of temperatures and forming rates carried out.

  7. Experimental and Numerical Studies on the Formability of Materials in Hot Stamping and Cold Die Quenching Processes

    SciTech Connect

    Li, N.; Mohamed, M. S.; Cai, J.; Lin, J.; Balint, D.; Dean, T. A.

    2011-05-04

    Formability of steel and aluminium alloys in hot stamping and cold die quenching processes is studied in this research. Viscoplastic-damage constitutive equations are developed and determined from experimental data for the prediction of viscoplastic flow and ductility of the materials. The determined unified constitutive equations are then implemented into the commercial Finite Element code Abaqus/Explicit via a user defined subroutine, VUMAT. An FE process simulation model and numerical procedures are established for the modeling of hot stamping processes for a spherical part with a central hole. Different failure modes (failure takes place either near the central hole or in the mid span of the part) are obtained. To validate the simulation results, a test programme is developed, a test die set has been designed and manufactured, and tests have been carried out for the materials with different forming rates. It has been found that very close agreements between experimental and numerical process simulation results are obtained for the ranges of temperatures and forming rates carried out.

  8. Thermal Neutron Die-Way-Time Studies for P and DGNAA of Radioactive Waste Drums at the MEDINA Facility

    SciTech Connect

    Mildenberger, Frank; Mauerhofer, Eric

    2015-07-01

    In Germany, radioactive waste with negligible heat production has to pass through a process of quality checking in order to check its conformance with national regulations prior to its transport, intermediate storage and final disposal. Additionally to its radioactive components, the waste may contain non-radioactive chemically toxic substances that can adversely affect human health and pollute the environment, especially the ground water. After an adequate decay time, the waste radioactivity will become harmless but the non-radioactive substances will persist over time. In principle, these hazardous substances may be quantified from traceability and quality controls performed during the production of the waste packages. As a consequence, a research and development program was initiated in 2007 with the aim to develop a nondestructive analytical technique for radioactive waste packages based on prompt and delayed gamma neutron activation analysis (P and DGNAA) employing a DT-neutron generator in pulsed mode. In a preliminary study it was experimentally demonstrated that P and DGNAA is suitable to determine the chemical composition of large samples. In 2010 a facility called MEDINA (Multi Element Detection based on Instrumental Neutron Activation) was developed for the qualitative and quantitative determination of nonradioactive, toxic elements and substances in 200-l steel drums. The determination of hazardous substances and elements is generally achieved measuring the prompt gamma-rays induced by thermal neutrons. Additional information about the composition of the waste matrix could be derived measuring the delayed gamma-rays from short life activation products. However a sensitive detection of these delayed gamma-rays requires that thermal neutrons have almost vanished. Therefore, the thermal neutron die-away-time has to be known in order to achieve an optimal discrimination between prompt and delayed gamma-ray spectra acquisition. Measurements Thermal neutron

  9. 'Doubly deprived': a post-death qualitative study of primary carers of people who died in Western Australia.

    PubMed

    Keesing, Sharon; Rosenwax, Lorna; McNamara, Beverley

    2011-11-01

    This paper explores the daily experiences and occupational needs of family carers of people who were dying, with particular reference to their daily routines and ability to undertake other varied activities during the period of care. The impact of the caring experience on these occupations was then examined to determine how, and if, these occupational needs were addressed in the community using potential and available services. An exploratory approach using grounded theory was employed to examine these experiences. Participants were recruited from metropolitan (n = 10) and rural (n = 4) locations across Western Australia between February and June 2009, using a purposive sampling method. A semi-structured interview guide was developed following consultation with the literature, expert opinion and piloting. Interviews were conducted in participants' homes and questions were asked about their experiences as a carer including routines, engagement in usual activities and the impact of the caring role on their daily life during and after the period of care. Each interview was transcribed verbatim and analysed to determine potential themes. Two important themes were identified: (1) Carers experienced disengagement and deprivation from their usual occupations during and after the period of care; and (2) Participants described significant disempowerment in their role as carer. Carers are 'doubly disadvantaged' as a result of their caring role; they are unable to participate in their usual occupations and they are not recognised for their contributions as carers. Carers experienced disengagement and deprivation from their usual occupations, contributing to physical, psychological and emotional difficulties and this may result in long term consequences for health and well-being. In addition, the current services and support available for carers in the community are deemed inadequate; placing further stress on a health care system which needs to cope with increasing

  10. ACLCP Periodical Storage Center: Feasibility Study, September 1974-April 1975.

    ERIC Educational Resources Information Center

    Cieslicki, Dorothy

    A study of alternative models for establishing a cooperative storage center for little used library materials by the members of the Area College Libraries of Central Pennsylvania (ACLCP) focused on periodicals. Considerations discussed include advantages--lower cost; space for growth and better access to holdings retained in active collections;…

  11. Studies of the Long Secondary Periods in Pulsating Red Giants

    NASA Astrophysics Data System (ADS)

    Percy, J. R.; Deibert, E.

    2016-12-01

    We have used systematic, sustained visual observations from the AAVSO International Database and the AAVSO time-series analysis package VSTAR to study the unexplained "long secondary periods" (LSPs) in 27 pulsating red giants. In our sample, the LSPs range from 479 to 2967 days, and are on average 8.1 +/- 1.3 times the excited pulsation period. There is no evidence for more than one LSP in each star. In stars with both the fundamental and first overtone radial period present, the LSP is more often about 10 times the latter. The visual amplitudes of the LSPs are typically 0.1 magnitude and do not correlate with the LSP. The phase curves tend to be sinusoidal, but at least two are sawtooth. The LSPs are stable, within their errors, over the timespan of our data, which is typically 25,000 days. The amplitudes, however, vary by up to a factor of two or more on a time scale of roughly 20-30 LSPs. There is no obvious difference between the carbon (C) stars and the normal oxygen (M) stars. Previous multicolor observations showed that the LSP color variations are similar to those of the pulsation period, and of the LSPs in the Magellanic Clouds, and not like those of eclipsing stars. We note that the LSPs are similar to the estimated rotation periods of the stars, though the latter have large uncertainties. This suggests that the LSP phenomenon may be a form of modulated rotational variability.

  12. A Study of the First Year of the End-of-Life Clinic for Physician-Assisted Dying in the Netherlands.

    PubMed

    Snijdewind, Marianne C; Willems, Dick L; Deliens, Luc; Onwuteaka-Philipsen, Bregje D; Chambaere, Kenneth

    2015-10-01

    Right to Die NL, an organization in the Netherlands that advocates for the option of euthanasia, founded the End-of-Life Clinic in 2012 to provide euthanasia or physician-assisted suicide for patients who meet all legal requirements but whose regular physicians rejected their request. Many patients whose requests are rejected have less common situations, such as a psychiatric or psychological condition, dementia, or being tired of living. To study outcomes of requests for euthanasia or physician-assisted suicide received by the clinic and factors associated with granting or rejecting requests. Analysis of application forms and registration files from March 1, 2012, to March 1, 2013, the clinic's first year of operation, for 645 patients who applied to the clinic with a request for euthanasia or physician-assisted suicide and whose cases were concluded during the study period. A request could be granted, rejected, or withdrawn or the patient could have died before a final decision was reached. We analyzed bivariate and multivariate associations with medical conditions, type of suffering, and sociodemographic variables. Of the 645 requests made by patients, 162 requests (25.1%) were granted, 300 requests (46.5%) were refused, 124 patients (19.2%) died before the request could be assessed, and 59 patients (9.1%) withdrew their requests. Patients with a somatic condition (113 of 344 [32.8%]) or with cognitive decline (21 of 56 [37.5%]) had the highest percentage of granted requests. Patients with a psychological condition had the smallest percentage of granted requests. Six (5.0%) of 121 requests from patients with a psychological condition were granted, as were 11 (27.5%) of 40 requests from patients who were tired of living. Physicians in the Netherlands have more reservations about less common reasons that patients request euthanasia and physician-assisted suicide, such as psychological conditions and being tired of living, than the medical staff working for the End

  13. Which hospice patients with cancer are able to die in the setting of their choice? Results of a retrospective cohort study.

    PubMed

    Jeurkar, Neha; Farrington, Sue; Craig, Teresa R; Slattery, Julie; Harrold, Joan K; Oldanie, Betty; Teno, Joan M; Casarett, David J

    2012-08-01

    To determine which hospice patients with cancer prefer to die at home and to define factors associated with an increased likelihood of dying at home. An electronic health record-based retrospective cohort study was conducted in three hospice programs in Florida, Pennsylvania, and Wisconsin. Main measures included preferred versus actual site of death. Of 7,391 patients, preferences regarding place of death were determined at admission for 5,837 (79%). After adjusting for other characteristics, patients who preferred to die at home were more likely to die at home (adjusted proportions, 56.5% v 37.0%; odds ratio [OR], 2.21; 95% CI, 1.77 to 2.76). Among those patients (n = 3,152) who preferred to die at home, in a multivariable logistic regression model, patients were more likely to die at home if they had at least one visit per day in the first 4 days of hospice care (adjusted proportions, 61% v 54%; OR, 1.23; 95% CI, 1.07 to 1.41), if they were married (63% v 54%; OR, 1.35; 95% CI, 1.10 to 1.44), and if they had an advance directive (65% v 50%; OR, 2.11; 95% CI, 1.54 to 2.65). Patients with moderate or severe pain were less likely to die at home (OR, 0.56; 95% CI, 0.45 to 0.64), as were patients with better functional status (higher Palliative Performance Scale score: < 40, 64.8%; 40 to 70, 50.2%; OR, 0.79; 95% CI, 0.67 to 0.93; > 70, 40.5%; OR, 0.53; 95% CI, 0.35 to 0.82). Increased hospice visit frequency may increase the likelihood of patients being able to die in the setting of their choice.

  14. Die spacer thickness reproduction for central incisor crown fabrication with combined computer-aided design and 3D printing technology: an in vitro study.

    PubMed

    Hoang, Lisa N; Thompson, Geoffrey A; Cho, Seok-Hwan; Berzins, David W; Ahn, Kwang Woo

    2015-05-01

    The inability to control die spacer thickness has been reported. However, little information is available on the congruency between the computer-aided design parameters for die spacer thickness and the actual printout. The purpose of this study was to evaluate the accuracy and precision of the die spacer thickness achieved by combining computer-aided design and 3-dimensional printing technology. An ivorine maxillary central incisor was prepared for a ceramic crown. The prepared tooth was duplicated by using polyvinyl siloxane duplicating silicone, and 80 die-stone models were produced from Type IV dental stone. The dies were randomly divided into 5 groups with assigned die spacer thicknesses of 25 μm, 45 μm, 65 μm, 85 μm, and 105 μm (n=16). The printed resin copings, obtained from a printer (ProJet DP 3000; 3D Systems), were cemented onto their respective die-stone models with self-adhesive resin cement and stored at room temperature until sectioning into halves in a buccolingual direction. The internal gap was measured at 5 defined locations per side of the sectioned die. Images of the printed resin coping/die-stone model internal gap dimensions were obtained with an inverted bright field metallurgical microscope at ×100 magnification. The acquired digital image was calibrated, and measurements were made using image analysis software. Mixed models (α=.05) were used to evaluate accuracy. A false discovery rate at 5% was used to adjust for multiple testing. Coefficient of variation was used to determine the precision for each group and was evaluated statistically with the Wald test (α=.05). The accuracy, expressed in terms of the mean differences between the prescribed die spacer thickness and the measured internal gap (standard deviation), was 50 μm (11) for the 25 μm group simulated die spacer thickness, 30 μm (10) for the 45 μm group, 15 μm (14) for the 65 μm group, 3 μm (23) for the 85 μm group, and -10 μm (32) for the 105 μm group. The

  15. Control in the Middle (CIM) for Three Period Crossover Studies

    PubMed Central

    Shuster, Jonathan; Anton, Stephen D.; Theriaque, Douglas; Yoon, Saunjoo

    2012-01-01

    Three period crossover studies can be efficient and convenient methods of conducting Phase II clinical trials. Non-randomly placing control in the middle (CIM) has not been practiced, but may be extremely useful in studies testing herbal products for which placebos are not available, or for distinguishing between behavioral and biological effects. Furthermore, this design can serve as a valuable addition to classical studies of either (a) two competing treatments or (b) treatment versus placebo versus an open label “nothing” as the control. Therefore, we propose rigorous designs that will help practitioners efficiently answer research questions where (1) two active treatments need to be compared against each other with treatment vs. placebo comparisons of secondary importance; (2) a single active treatment needs to be tested where no placebo is available; or (3) the placebo effect is of interest in a treatment vs. placebo trial. For studies where no placebo is available, deception will be required, with participants told that in one randomly selected period (#1 or #3) they will receive the active treatment, and that they will receive a new experimental inert placebo in the other period. Assuming this design is approved by an ethics committee, it can be very useful in biomedical research. PMID:21509714

  16. Facing Finality: Cognitive and Cultural Studies on Death and Dying "Arabic Culture"

    ERIC Educational Resources Information Center

    Al-Meshhedany, Amna A. Hasan; Al-Sammerai, Nabiha S. Mehdi

    2010-01-01

    Semantics is a study of human beings cultural background, has from its beginning as a field of study been concerned with the study of humans understanding of culture. Understanding the meaning of "death" has been of great importance to many of the central theoretical developments in this field, especially as it imposes on studies of…

  17. A contribution to the study of asteroids with longrotational period

    NASA Astrophysics Data System (ADS)

    Angeli, Cláudia A.; Lazzaro, Daniela; Florczak, Marcos A.; Betzler, Alberto S.; Carvano, Jorge M.

    1999-05-01

    The analysis of the asteroid rotation periods can give us information about the collisionalevolution of the asteroid population. Several works aiming to understand the global collisionalevolution of the asteroids have been undertaken since the seventies. McAdoo and Burns (1973), analysing 64 rotation periods known at that time, concluded that the smaller asteroids rotatefaster than the larger ones. Later, studying a sample of 182 asteroids, Harris and Burns (1979)also concluded that there was a tendency for smaller asteroids to rotate faster than larger ones. Therotation rate dispersions seemed to be consistent with a tridimensional Maxwellian distribution, aswe suppose would be the case for a collisionally evolved system. On the other hand, Tedesco and Zappala`<⧸a> (1980), analysing data for 134 main belt asteroids, did not finda defined relationship between asteroid sizes and rotation rates, even if they identified a largeasteroid group (D ⩾ 175 km) which seemed to rotate faster than the other asteroids in thesample. Burns and Tedesco (1979)also concluded that the asteroids with D > 175 kmrotate faster than the others. Like other authors, they concluded that a much larger database wouldbe necessary to confirm this tendency. Dermott and Murray (1982)have analysedthe same sample of 134 asteroids studied by Tedesco and Zappala`<⧸a> (1980)and have shown that the rotation frequencies were dependent on the asteroid taxonomic type anddiameter. Farinella et al. (1981)have reanalysed Harris and Burns (1979)and Tedesco and Zappala`<⧸a> (1980) results, concluding that the larger asteroids rotatefaster than those of intermediate size. They also suggested that it seemed to have an excess of slowrotators among the asteroids of small to intermediate size. Dermott et al. (1984)and Binzel (1984), analyzing samples of 217 and 66 objects, respectively, suggested the existence oftwo populations: the slow and the fast asteroids. Binzel

  18. Communication and trust in the care provided to a dying parent: a nationwide study of cancer-bereaved youths.

    PubMed

    Grenklo, Tove Bylund; Kreicbergs, Ulrika C; Valdimarsdóttir, Unnur A; Nyberg, Tommy; Steineck, Gunnar; Fürst, Carl Johan

    2013-08-10

    To assess children's trust in the care provided to a dying parent during the final week of life in relation to end-of-life medical information about disease, treatment, and death. This nationwide population-based survey included 622 (73%) of 851 youths who, 6 to 9 years earlier, at age 13 to 16 years, lost a parent to cancer. We asked about the children's reception of end-of-life professional information and trust in the care provided. We also asked about depression and several potential risk factors of distrust in the care provided. A majority (82%) reported moderate/very much trust in the care provided. Compared with children who received end-of-life medical information before their loss, the risk of distrust in the care provided was higher in those who received no information (risk ratio [RR], 2.5; 95% CI, 1.5 to 4.1), in those who only received information afterward (RR, 3.2; 95% CI, 1.7 to 5.9), and in those who did not know or remember if end-of-life medical information was provided (RR, 1.7; 95% CI, 1.1 to 2.5). Those reporting distrust in the care provided had an RR of 2.3 (95% CI, 1.5 to 3.5) for depression. Furthermore, the risk of distrust in the care provided was higher among children reporting poor efforts to cure (RR, 5.1; 95% CI, 3.6 to 7.3), and/or a poor relationship with the surviving parent (RR, 2.9; 95% CI, 2.0 to 4.1). Our study suggests that children's trust in the care provided to a dying parent was highest when they received end-of-life medical information before their loss.

  19. A Review of OIE Country Status Recovery Using Vaccinate-to-Live Versus Vaccinate-to-Die Foot-and-Mouth Disease Response Policies II: Waiting Periods After Emergency Vaccination in FMD Free Countries.

    PubMed

    Geale, D W; Barnett, P V; Clarke, G W; Davis, J; Kasari, T R

    2015-08-01

    For countries with OIE status, FMD free country where vaccination is not practised, vaccinate-to-live policies have a significant economic disincentive as the trade restriction waiting period is double that of vaccinate-to-die policies. The disposal of healthy vaccinated animals strictly for the purpose of regaining markets with debatable scientific justification is a global concern. The feasibility of aligning the waiting periods to facilitate vaccinate-to-live is explored. The first article of this two-part review (Barnett et al., 2015) explored the qualities of higher potency Foot-and-Mouth Disease (FMD) vaccines, performance of differentiating infected from vaccinated animals (DIVA) diagnostic assays particularly in vaccinates and carriers, as well as aspects of current limitations of post-outbreak surveillance. Here, the history behind the OIE waiting periods for FMD free status is reviewed as well as whether the risk of vaccinated animals and their subsequent products differ appreciably at 3 versus 6 months. It is concluded that alignment is feasible for vaccinate-to-live using higher potency FMD vaccines within the current OIE waiting period framework of 3 and 6 months blocks of time. These waiting periods reflect precedence, historical practicalities and considered expert opinion rather than a specific scientific rationale. The future lies in updated epidemiological and diagnostic technology to establish an acceptable level of statistical certainty for surveillance or target probability of freedom of FMDV (infection or circulation) not time restricted waiting periods. The OIE Terrestrial Code limits trade from a FMD free country where vaccination is not practiced to animal products and live non-vaccinated animals. The risk of FMDV in products derived from higher potency vaccinated animals is appreciably less than for countries with infected FMD status or even from a FMD free country where vaccination is practised for which the Code has Articles with

  20. Geodetic reference systems for long period studies in earth physics

    NASA Technical Reports Server (NTRS)

    Mather, R. S.

    1973-01-01

    A simple system of reference axes is defined for possible use in high precision geodetic studies over long periods of time for programs in earth physics. The proposed system is based on the gravitational and dynamic characteristics of the axis of rotation and the earth's center of mass as defined instantaneously at a given epoch. Techniques are outlined for its continuous representation over time intervals of significance for studies in earth physics. The relationship between the proposed system and the representation of extra-terrestrial objects using the celestial sphere concept is also discussed.

  1. Treating Palliative Care Patients with Pain with the Body Tambura: A Prospective Case Study at St. Joseph's Hospice for Dying destitute in Dindigul South India.

    PubMed

    Dietrich, Cordula; Teut, M; Samwel, Kakuko Lopoyetum; Narayanasamy, S; Rathapillil, T; Thathews, G

    2015-01-01

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

  2. Treating Palliative Care Patients with Pain with the Body Tambura: A Prospective Case Study at St. Joseph's Hospice for Dying destitute in Dindigul South India

    PubMed Central

    Dietrich, Cordula; Teut, M; Samwel, Kakuko Lopoyetum; Narayanasamy, S; Rathapillil, T; Thathews, G

    2015-01-01

    Background: The Body Tambura is a recently invented stringed instrument that is used for receptive music therapy designed to be placed and attached on the human body. The aim of this study was to record perceived effects of a treatment with the Body Tambura on palliative care patients with special reference to pain. Materials and Methods: A prospective case study was carried out with patients of St. Joseph's Hospice for Dying Destitute in Dindigul/South India. Patients were treated with a treatment after baseline assessment and also on the next day. Outcomes were measured quantitatively by using a numeric rating scale (0–10, 10 maximum intensity of pain felt) at baseline, directly after treatment, and the day after the treatment to determine the intensity of the pain. Results: Ten patients (five women and five men) participated in the study. The majority described the therapy as a pleasant experience. The pain intensity at baseline was reduced from 8.3 ± standard deviation (SD) 1.16 to 4.6 ± 1.52 at day 1 and from 4.6 ± 2.07 to 2.4 ± 1.58 at day 2. Conclusion: A clinically relevant pain reduction was described as short time outcome; the therapy was received and perceived well. Forthcoming research should include a control group, randomization, a larger number of participants, and a longer period of treatment. PMID:26009680

  3. How do surgeons experience and cope with the death and dying of their patients? A qualitative study in the context of life-limiting illnesses.

    PubMed

    Zambrano, Sofia C; Chur-Hansen, Anna; Crawford, Gregory B

    2013-05-01

    The present qualitative study explores surgeons' experiences and coping mechanisms with the death of their patients in the context of life-limiting illnesses. Nine Australian surgeons participated in in-depth interviews. Thematic analysis of the interview transcriptions allowed for identification of themes and subthemes. Methodological trustworthiness and rigor were preserved at all stages of the research process. The essence of surgical practice, comprising participants' descriptions of their identity as surgeons, influenced their experiences and coping mechanisms when dealing with death and dying. The following subthemes were identified: distancing from patients, wanting to fix problems, doing in terms of operating on a patient, prominence of the surgeon's personal ability, and high personal responsibility for patient outcomes. Giving hope and having a mixed surgical practice were some of the coping mechanisms described by participants. Death and dying are a part of surgical practice, and surgeons face challenges as they care for dying patients. Although participants stated that they felt less affected by dealing with patients dying of life-limiting illnesses than by unexpected deaths, their descriptions of their encounters, reactions, and behaviors, as well as their use of language, suggest that these deaths have a lasting impact. Potential areas for improvement of surgical practice and approaches to teaching about death and dying in surgery are addressed. Furthermore, the results of this study suggest the need to expand research in this area.

  4. "Die Kultur der Weimarer Republik" as a Transitional Course between Language Instruction and Literature Study.

    ERIC Educational Resources Information Center

    Thomann Tewarson, Heidi

    1982-01-01

    Discusses the course "Weimar Culture" as a means of encouraging further German study and as an alternative to a literature course. Outlines the course readings and viewings, the major problems and areas of concentration, and the focal point of each unit. (EKN)

  5. "It is Possible to Die Before Being Born". Negative Integers Subtraction: A Case Study

    ERIC Educational Resources Information Center

    Gallardo, Aurora

    2003-01-01

    A Case Study is presented in this article, where there is a contradiction between pre-algebraic language semantic and syntax used to solve word problems through a negative integers subtraction. Appendix includes answer key. (Contains 1 figure.) [For complete proceedings, see ED500859.

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

    ERIC Educational Resources Information Center

    Tait, Glendon R.; Hodges, Brian D.

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Tait, Glendon R.; Hodges, Brian D.

    2013-01-01

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

  8. A descriptive study of elderly patients with dementia who died wandering outdoors in Kochi Prefecture, Japan.

    PubMed

    Furumiya, Junichi; Hashimoto, Yoshiaki

    2015-05-01

    This was a descriptive study of elderly persons with dementia who were found dead after becoming lost in the community. Nineteen forensic autopsy cases were performed at Kochi Medical School, Japan. The mean age of the patients (9 males and 10 females) was 82.1 ± 6.6 years. Causes of death were drowning (n = 8), trauma (n = 5), hypothermia (n = 2), and debilitation possibly due to fatigue (n = 1) or were unknown (n = 3). Thirteen (68%) individuals had been reported missing, most at least 6 hours after they had left. They moved on foot (n = 14), by car (n = 3), or by bicycle (n = 2). Distances from residences to spots of death ranged from 20 to 5800 m for 11 patients on foot. In 8 cases, it was less than 500 m. The study has potential implications for enabling their early discovery and protection.

  9. The impacts of maternal mortality and cause of death on children's risk of dying in rural South Africa: evidence from a population based surveillance study (1992-2013).

    PubMed

    Houle, Brian; Clark, Samuel J; Kahn, Kathleen; Tollman, Stephen; Yamin, Alicia

    2015-05-06

    Maternal mortality, the HIV/AIDS pandemic, and child survival are closely linked. This study contributes evidence on the impact of maternal death on children's risk of dying in an HIV-endemic population in rural South Africa. We used data for children younger than 10 years from the Agincourt health and socio-demographic surveillance system (1992 - 2013). We used discrete time event history analysis to estimate children's risk of dying when they experienced a maternal death compared to children whose mother survived (N=3,740,992 child months). We also examined variation in risk due to cause of maternal death. We defined mother's survival status as early maternal death (during pregnancy, childbirth, or within 42 days of most recent childbirth or identified cause of death), late maternal death (within 43-365 days of most recent childbirth), any other death, and mothers who survived. Children who experienced an early maternal death were at 15 times the risk of dying (RRR 15.2; 95% CI 8.3-27.9) compared to children whose mother survived. Children under 1 month whose mother died an early (p=0.002) maternal death were at increased risk of dying compared to older children. Children whose mothers died of an HIV/AIDS or TB-related early maternal death were at 29 times the risk of dying compared to children with surviving mothers (RRR 29.2; 95% CI 11.7-73.1). The risk of these children dying was significantly higher than those children whose mother died of a HIV/AIDS or TB-related non-maternal death (p=0.017). This study contributes further evidence on the impact of a mother's death on child survival in a poor, rural setting with high HIV prevalence. The intersecting epidemics of maternal mortality and HIV/AIDS - especially in sub-Saharan Africa - have profound implications for maternal and child health and well-being. Such evidence can help guide public and primary health care practice and interventions.

  10. 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.

  11. 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.

  12. 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.

  13. Taking care of a dying grandparent: case studies of grandchildren in the hospice caregiver role.

    PubMed

    Boquet, Jaime R; Oliver, Debra Parker; Wittenberg-Lyles, Elaine; Doorenbos, Ardith Z; Demiris, George

    2011-12-01

    This study aims to provide insight into the role of grandchildren as informal hospice caregivers. It presents 4 cases that highlight the challenges and perceptions of grandchildren who care for a grandparent at the end of life. A researcher met regularly with family caregivers to discuss the problems or challenges during hospice caregiving. Although each caregiver presented unique individual experiences, several themes are common among the family caregivers including fatigue, stress, guilt, and loss of the "grandchild" identity. Grandchildren caregivers often take care of 3 generations (grandparents, parents, and children) and in many cases need additional assistance to help them overcome the challenges associated with managing a household, career, family, and caregiving roles.

  14. Families' experiences with patients who died after assisted suicide: a retrospective interview study in southern Switzerland.

    PubMed

    Gamondi, C; Pott, M; Payne, S

    2013-06-01

    In Switzerland, if certain conditions are met, assisted suicide is not prosecuted. International debate suggests that requests for hasten death are often altered by the provision of palliative care. Aims of the study were to explore patients' reasons for choice of assisted suicide and family perceptions of the interactions with health care professionals. This is a qualitative study upon 11 relatives of 8 patients cared for by a palliative care team, deceased of assisted suicide. Pain and symptom burden were not regarded by patients as key reasons to seek assisted suicide: existential distress and fear of loss of control were the determinants. Most patients had made pre-illness decisions to use assisted suicide. A general need for perceived control and fear of dependency were reported as a common characteristic of these patients. Patients held misunderstandings about the nature and purpose of palliative care, and the interviewed indicated that patients did not regard provision of palliative care services as influential in preventing their decision. Assisted suicide was preferred despite provision of palliative care. Better understanding of the importance placed on perceived control and anticipated dependency is needed. Further research is needed to develop appropriate support for patients contemplating assisted suicide.

  15. The numerical study of the influence of rheological parameters stratified flows characteristics in cable dies

    NASA Astrophysics Data System (ADS)

    Kozitsyna, M. V.; Trufanova, N. M.

    2017-01-01

    Today the process of coextrusion is the most technological in the cable production with cross-linked polyethylene, composed of two or more layers of polymeric insulation. Since the covering technology is a simultaneous imposition of all necessary layers (two semiconducting shields on the insulation and conductor and one - on insulation), the main focus of this study is the analysis of significance of various factors influence on stratified flows characteristics. This paper has considered the flow of two abnormally viscous liquids in the cable head. The problem has been solved through a three-dimensional statement by applying the finite element method in the Ansys software package. The influence has been estimated by varying the rheological properties of materials to create all necessary layers thickness.

  16. Physicians' willingness to grant requests for assistance in dying for children: a study of hypothetical cases.

    PubMed

    Vrakking, Astrid M; van der Heide, Agnes; Looman, Caspar W N; van Delden, Johannes J M; Onwuteaka-Philipsen, Bregje D; van der Maas, Paul J; van der Wal, Gerrit

    2005-05-01

    To study the willingness of Dutch physicians to use potentially life-shortening or lethal drugs for severely ill children. We asked 63 pediatricians about their approach to 10 hypothetical cases of children with cancer. The age of the child (15, 11, or 6 years), the child's (explicit) request, and the opinion of the parents varied. Two hypothetical cases were also presented to 125 general practitioners and 208 clinical specialists. Most pediatricians were willing to increase morphine in all cases. A total of 48% to 60% of pediatricians were willing to use lethal drugs in children at the child's request, when the parents agreed; when parents requested ending of life of their unconscious child, 37% to 42% of pediatricians were willing; 13% to 28% of pediatricians were willing when parents did not agree with their child's request. General practitioners and clinical specialists were as willing as pediatricians to use lethal drugs at the child's request, but less willing to grant a request of parents for their unconscious child. Many Dutch pediatricians are willing to use potentially life-shortening or lethal drugs for children. The legal limit of 12 years, as the age under which voluntary euthanasia is forbidden, is not fully supported by Dutch physicians.

  17. 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…

  18. 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…

  19. A novel periodic boundary condition for computational hemodynamics studies.

    PubMed

    Bahramian, Fereshteh; Mohammadi, Hadi

    2014-07-01

    In computational fluid dynamics models for hemodynamics applications, boundary conditions remain one of the major issues in obtaining accurate fluid flow predictions. For major cardiovascular models, the realistic boundary conditions are not available. In order to address this issue, the whole computational domain needs to be modeled, which is practically impossible. For simulating fully developed turbulent flows using the large eddy simulation and dynamic numerical solution methods, which are very popular in hemodynamics studies, periodic boundary conditions are suitable. This is mainly because the computational domain can be reduced considerably. In this study, a novel periodic boundary condition is proposed, which is based on mass flow condition. The proposed boundary condition is applied on a square duct for the sake of validation. The mass-based condition was shown to obtain the solution in 15% less time. As such, the mass-based condition has two decisive advantages: first, the solution for a given Reynolds number can be obtained in a single simulation because of the direct specification of the mass flow, and second, simulations can be made more quickly.

  20. Hypokalaemic Periodic Paralysis– A Prospective Study of the Underlying Etiologies

    PubMed Central

    Jandhyala, Surya Narayana; Belle, Jayaprakash; Rau, N.R; Shetty, Ranjan

    2015-01-01

    Background Hypokalaemic periodic paralysis (HPP) is a rare muscular disorder characterised by episodic weakness associated with hypokalaemia. The disease can either be inherited or acquired and misdiagnosis of the disease is quite common. Most of the data available on the disease is from the western world. Studies reporting aetiological, clinical and metabolic profiles of Indian population are sparse. Hence we tried to provide insights of the disease among the Indian population. Aim To study the aetiological, clinical and metabolic profile of patients diagnosed with Hypokalaemic Periodic Paralysis (HPP). Materials and Methods This is an observational and analytical study on HPP diagnosed patients, during September 2011 to September 2014 in Kasturba Hospital, Manipal. A total of 23 patients were studied. Detailed history, clinical evaluation and metabolic workup for secondary causes of HPP were analysed. Results Of the 23 patients, 57% had primary HPP while 43% had secondary HPP. The group of patients with primary HPP comprised of 92% males and 8% females with mean age of 28 years and the mean duration of symptoms of 18 hours. The group with secondary HPP comprised of 70% males and 30% females with mean age of 38.7 years and the mean duration of symptoms of 60 hours. The secondary causes of HPP were thyrotoxicosis (50%), infective diarrhea (20%), Crohn’s disease (10%), renal tubular acidosis (RTA) Type I (10%) and Conn’s syndrome (10%). Conclusion In our study primary HPP was found to be more common than secondary HPP. Males were predominantly affected in both groups. HPP should be ruled out before starting therapy for Guillain-Barré Syndrome (GBS). PMID:26500936

  1. Development of the Draft Clinical Guideline on How to Resuscitate Dying Patients in the Iranian Context: A Study Protocol

    PubMed Central

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

    2016-01-01

    Introduction: The guidelines can be used as a model to guide the implementation of the best options and a suitable framework for clinical decisions. Even a guideline can largely help in challenging problems such as not to resuscitate with high cultural and value load. The guidelines try to improve the health care quality through reducing the treatment costs and variety of care measures. This study aimed to prepare a draft of clinical guidelines with the main aim of designing and drafting the clinical guideline on resuscitation in dying patients. Methodology: After selecting the subject of this guideline, in the first meeting of the team members of drafting the guideline, the guideline scope was determined. Then, the literature review done without time limitation, through searching electronic bibliographic information and internet databases and sites such as Medline, EMBASE, Springer, Blackwell Synergy, Elsevier, Scopus, Cochran Library and also databases including SID, Iran Medex, and Magiran. The experts will be the interviewed, and the interviews are directed content analysis. Conclusion: Finally, recommendations will be formed by nominal group technique. This study protocol includes informative information for designing and conducting of health professionals intending to create a direct on qualitative, theoretical, philosophical, spiritual, and moral health aspects. PMID:27559265

  2. Numerical simulation and experimental study for the die forging process of a high-speed railway brake disc hub

    NASA Astrophysics Data System (ADS)

    Sun, Mingyue; Xu, Bin; Zhang, Long; LI, Dianzhong

    2013-05-01

    With the aim of manufacturing a near-net shape forging product of a brake disk hub for the high-speed railway, the die forging process was designed and optimized in this study. Firstly, based on the measured stress-strain curves at different strain rates and the thermal-physical parameters of 40Cr A steel, a finite element model for the forging process of a high-speed railway brake disc hub was established. Then, the temperature, stress and strain fields were studied and analyzed at the pre-forging and the finial-forging stages. Besides, in order to trace the stress and strain evolution, five points at different positions were chosen on the billet, and the comparison of the state conditions was made among these points. The results have demonstrated that the product can be well formed by an elaborately designed three-stage forging process, which may reduce the metal machine allowance and the producing cost effectively. Finally, an industrial trial was made and a machined product with sound quality was obtained.

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

    PubMed

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

    2003-02-15

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

  4. Fear of dying in an ethnically diverse society: cross-sectional studies of people aged 65+ in Britain

    PubMed Central

    Iliffe, Steve; Kessel, Anthony; Higginson, Irene J

    2010-01-01

    Aim To examine fears about dying in an ethnically diverse population sample, and a more homogeneous population sample, aged 65 and over. Methods Personal interviews with people aged 65+ living at home responding to two Office for National Statistics Omnibus Surveys in Britain, and two Ethnibus Surveys of ethnically diverse populations in Britain. Results Ethnically diverse respondents were more likely than British population respondents to express fears about dying on all measures used. Respondents in both samples with better, compared with worse, quality of life had significantly reduced odds of having extreme fears of dying (ethnically diverse sample, OR 0.924 (95% CI 0.898 to 0.951); British population sample, OR 0.981 (95% CI 0.966 to 0.996); both p<0.001). In the latter sample only, older age was protective (OR 0.957; 95% CI 0.930 to 0.985; p<0.001), whereas in the Ethnibus sample, having a longstanding illness (OR 2.024; 95% CI 1.158 to 3.535; p<0.05) and having more relatives to help them (OR 1.134; 95% CI 1.010 to 1.274; p<0.05) increased fears about dying. Conclusions Enabling older people to express fears about dying is likely to be important when planning supportive end-of-life care. Practitioners should not assume that fears about dying are the same in different social groups, or that extensive family support is protective against such anxiety. Older people from ethnic minorities had more anxieties about dying than others, and were more likely to express fears the more extensive their family support. These findings have implications for commissioners and practitioners of primary and secondary care. PMID:20354041

  5. Fear of dying in an ethnically diverse society: cross-sectional studies of people aged 65+ in Britain.

    PubMed

    Bowling, Ann; Iliffe, Steve; Kessel, Anthony; Higginson, Irene J

    2010-04-01

    To examine fears about dying in an ethnically diverse population sample, and a more homogeneous population sample, aged 65 and over. Personal interviews with people aged 65+ living at home responding to two Office for National Statistics Omnibus Surveys in Britain, and two Ethnibus Surveys of ethnically diverse populations in Britain. Ethnically diverse respondents were more likely than British population respondents to express fears about dying on all measures used. Respondents in both samples with better, compared with worse, quality of life had significantly reduced odds of having extreme fears of dying (ethnically diverse sample, OR 0.924 (95% CI 0.898 to 0.951); British population sample, OR 0.981 (95% CI 0.966 to 0.996); both p<0.001). In the latter sample only, older age was protective (OR 0.957; 95% CI 0.930 to 0.985; p<0.001), whereas in the Ethnibus sample, having a longstanding illness (OR 2.024; 95% CI 1.158 to 3.535; p<0.05) and having more relatives to help them (OR 1.134; 95% CI 1.010 to 1.274; p<0.05) increased fears about dying. Enabling older people to express fears about dying is likely to be important when planning supportive end-of-life care. Practitioners should not assume that fears about dying are the same in different social groups, or that extensive family support is protective against such anxiety. Older people from ethnic minorities had more anxieties about dying than others, and were more likely to express fears the more extensive their family support. These findings have implications for commissioners and practitioners of primary and secondary care.

  6. A study of long-period mantle wave scattering

    NASA Astrophysics Data System (ADS)

    Meschede, M.; Romanowicz, B. A.

    2013-12-01

    This study examines long-period mantle wave scattering on the global scale. To this end, we extend a set of existing long wavelength global tomographic shear-velocity models with a random von-Karman model to add heterogeneities at much smaller scales. The spectrum of the random model is chosen to match the power of regional models at small scales and to transfer smoothly to the global model at long scales. Because such a model includes heterogeneities with realistic strengths at scales equal and smaller than wavelengths of long-period mantle signals (> 100s) we can examine the strong scattering regime. We use a spherical-harmonics multitaper approach to estimate the power spectrum of different regional models. We compare them to the power spectrum of global models estimated from the same region, and show that both spectra transfer reasonably smoothly into each other. The heterogeneity spectrum can be approximated by a von-Karman spectrum which is a decreasing power-law at short scales. We extend the global models in the upper mantle, based on these estimates of the short scale power spectra, and in the lower mantle, by extrapolation. Naturally, knowledge of the power spectrum alone, limits our models to realistic two-point correlations on short scales, neglecting higher orders. The consequences of such semi-statistical high-resolution models on the spectro-temporal behavior of long-period waveforms are analyzed using long time (> 30h) global spectral element simulations. We focus on measuring the scattering attenuation and the behavior of the envelopes to compare with real data and better constrain the spectral character of earth models at short wavelengths.

  7. Photoelectric UBV observations and period study of AK Herculis system

    NASA Astrophysics Data System (ADS)

    Awadalla, N. S.

    2003-09-01

    New photoelectric UBV observations of the W Ursae Majoris-type eclipsing binary AK Her are presented. The system exhibits many phenomena such as O'Connell effect, unequal depth, phase shift and different duration in secondary eclipse due to its totality, which have been studied. O'Connell effect-duration relation may be exist. The (O-C) curve has been obtained and the new light elements have been calculated. The analysis of the minima-times data of the system reveals possible sinusoidal orbital period variation (LITE). The study of the (O-C) curve, the light curves, O'Connell effect and the duration effect have led to that the system is likely a case which undergoes cyclic around the marginal contact state conservatively with mass transfers between its components, i.e. in TRO mode.

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

    PubMed Central

    2013-01-01

    Background Primary care physicians provide palliative home care. In cancer patients dying at home in the Netherlands (45% of all cancer patients) euthanasia in about one out of every seven patients indicates unbearable suffering. Symptom prevalence, relationship between intensity of symptoms and unbearable suffering, evolvement of symptoms and unbearability over time and quality of unbearable suffering were studied in end-of-life cancer patients in primary care. Methods 44 general practitioners during three years recruited cancer patients estimated to die within six months. Every two months patients quantified intensity as well as unbearability of 69 symptoms with the State-of-Suffering-V (SOS-V). Also overall unbearable suffering was quantified. The five-point rating scale ranged from 1 (not at all) to 5 (hardly can be worse). For symptoms assessed to be unbearable the nature of the suffering was additionally investigated with open-ended questions. The final interviews were analyzed; for longitudinal evolvement also the pre-final interviews were analyzed. Symptom intensity scores 4 and 5 were defined to indicate high intensity. Symptom unbearability scores 4 and 5 were defined to indicate unbearable suffering. Two raters categorized the qualitative descriptions of unbearable suffering. Results Out of 148 requested patients 51% participated; 64 patients were followed up until death. The SOS-V was administered at least once in 60 patients (on average 30 days before death) and at least twice in 33 patients. Weakness was the most frequent unbearable symptom (57%). Pain was unbearable in 25%. Pain, loss of control over one’s life and fear of future suffering frequently were unbearable (89-92%) when symptom intensity was high. Loss of control over one’s life, vomiting and not being able to do important things frequently were unbearable (52-80%) when symptom intensity was low. Unbearable weakness significantly increased between pre-final and final interview. Physical

  9. 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.

  10. Spiritual issues of people living and dying with advanced heart failure in Kenya: a qualitative serial interview study.

    PubMed

    Kimani, Kellen N; Murray, Scott A; Grant, Liz

    2016-01-01

    Exploring patients' spiritual issues is vital for informing holistic care. The spiritual concerns of patients living and dying with advanced heart failure in sub-Saharan Africa remains unknown. Our aim was to describe spiritual issues in the context of the lived experiences of patients with heart failure in Kenya. We purposively recruited 18 patients admitted with advanced heart failure at a rural district hospital in Kenya. We conducted serial in-depth interviews with patients at 0, 3 and 6 months after recruitment. We conducted bereavement interviews with their carers. Interviews were recorded, transcribed into English and analysed using a thematic approach, assisted by Nvivo software package. Patients expressed traditional and Christian spiritual beliefs in response to their illness. At diagnosis, some patients felt their illness had occurred because they had wronged God, while others felt betrayed by God. Some expressed comfort from God and optimism believing that God was in control and would heal their illness. During acute episodes patients questioned whether witchcraft or curses caused their illness. Younger patients experienced more spiritual distress. Although church fellowship generally offered spiritual and social support, some patients felt let down by the church which they perceived to favour those who offered more tithes. This is the first study to explore the spiritual issues of people living with advanced heart failure in Kenya. Understanding patients' spiritual concerns is important for developing evidence-based patient-centred holistic care to promote multidimensional well-being.

  11. A Comparative Evaluation of Accuracy of the Dies Affected by Tray Type, Material Viscosity, and Pouring Sequence of Dual and Single Arch Impressions- An In vitro Study

    PubMed Central

    Kulkarni, Rahul S.; Shah, Rupal J.; Chhajlani, Rahul; Saklecha, Bhuwan; Maru, Kavita

    2017-01-01

    Introduction The clinician’s skill, impression techniques, and materials play a very important role in recording fine details in an impression for accuracy of fixed partial denture prosthesis. Impression of prepared teeth and of the opposing arch can be recorded simultaneously by dual-arch trays, while the full arch metal trays are used for impressions of prepared teeth in one arch. Aim To measure and compare the accuracy of working dies made from impressions with metal and plastic dual arch trays and metal full arch trays, for two viscosities of impression material and by changing the sequence of pour of working and non-working sides. Materials and Methods A balanced design with independent samples was used to study the three variables (tray type, impression material viscosity, and pouring sequence). An impression made by dual arch trays and single arch trays were divided in to three groups (Group A-plastic dual arch tray, Group B-metal dual arch tray, Group C-full arch metal stock tray). Out of these three groups, two groups (Group A and B) were subdivided in to four subgroups each and one group (Group C) was subdivided in to two subgroups. A sample size of 30 was used in each subgroup yielding a total 300 impressions in three groups or ten subgroups. Impressions were made of a machined circular stainless steel die. All three dimensions (Occlusogingival, Mesiodistal, and Buccolingual) of the working dies as well as stainless steel standard die were measured three times, and the mean was used for the three standard sample values to which all working dies means were compared. Statistical analysis used for this study was a 3-factor analysis of variance with hypothesis testing at α =0.05. Results With respect to the selection of impression material viscosity statistically significant differences were found in the dies for the buccolingual and mesiodistal dimensions. Metal dual arch trays were slightly more accurate in the mesiodistal dimension in comparison to the

  12. A Comparative Evaluation of Accuracy of the Dies Affected by Tray Type, Material Viscosity, and Pouring Sequence of Dual and Single Arch Impressions- An In vitro Study.

    PubMed

    Kulkarni, Poonam R; Kulkarni, Rahul S; Shah, Rupal J; Chhajlani, Rahul; Saklecha, Bhuwan; Maru, Kavita

    2017-04-01

    The clinician's skill, impression techniques, and materials play a very important role in recording fine details in an impression for accuracy of fixed partial denture prosthesis. Impression of prepared teeth and of the opposing arch can be recorded simultaneously by dual-arch trays, while the full arch metal trays are used for impressions of prepared teeth in one arch. To measure and compare the accuracy of working dies made from impressions with metal and plastic dual arch trays and metal full arch trays, for two viscosities of impression material and by changing the sequence of pour of working and non-working sides. A balanced design with independent samples was used to study the three variables (tray type, impression material viscosity, and pouring sequence). An impression made by dual arch trays and single arch trays were divided in to three groups (Group A-plastic dual arch tray, Group B-metal dual arch tray, Group C-full arch metal stock tray). Out of these three groups, two groups (Group A and B) were subdivided in to four subgroups each and one group (Group C) was subdivided in to two subgroups. A sample size of 30 was used in each subgroup yielding a total 300 impressions in three groups or ten subgroups. Impressions were made of a machined circular stainless steel die. All three dimensions (Occlusogingival, Mesiodistal, and Buccolingual) of the working dies as well as stainless steel standard die were measured three times, and the mean was used for the three standard sample values to which all working dies means were compared. Statistical analysis used for this study was a 3-factor analysis of variance with hypothesis testing at α =0.05. With respect to the selection of impression material viscosity statistically significant differences were found in the dies for the buccolingual and mesiodistal dimensions. Metal dual arch trays were slightly more accurate in the mesiodistal dimension in comparison to the plastic trays in reference of tray selection and

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  15. Experimental study of periodic flow effects on spanwise vortex

    NASA Astrophysics Data System (ADS)

    Garcia Molina, Cruz Daniel; Lopez Sanchez, Erick Javier; Ruiz Chavarria, Gerardo; Medina Ovando, Abraham

    2014-11-01

    We present an experimental study about the spanwise vortex produced in a flow going out of a channel in shallow waters. This vortex travels in front of the dipole. The velocity field measurement was done using the PIV technique, and DPIVsoft (https://www.irphe.fr/ ~meunier/) was used for data processing. In this case the flow has a periodic forcing to simulate ocean tides. The experiment was conducted in a channel with variable width and the measurements were made using three different values of the aspect ratio width-depth. We present results of the position, circulation of this spanwise vortex and the flow inversion effect. The change of flow direction modify the intensity of the vortex, but it does not destroy it. The vertical components of the velocity field contributes particle transport. G. Ruiz Chavarria, E. J. Lopez Sanchez and C. D. Garcia Molina acknowledge DGAPA-UNAM by support under project IN 116312 (Vorticidad y ondas no lineales en fluidos).

  16. Does religiousness buffer against the fear of death and dying in late adulthood? Findings from a longitudinal study.

    PubMed

    Wink, Paul; Scott, Julia

    2005-07-01

    We used longitudinal data (N = 155) to investigate the relation between religiousness and fear of death and dying in late adulthood. We found no linear relations between religiousness and fear of death and dying. Individuals who were moderately religious feared death more than individuals who scored high or low on religiousness. Fear of death also characterized participants who lacked congruence between belief in an afterlife and religious practices. We replicated the curvilinear relation between fear of death and religiousness in late adulthood with religiousness in middle adulthood, controlling for sociodemographic variables, life satisfaction, social support, and stressors. Older participants (in their mid-70s) who experienced more bereavement and illness feared the dying process less than younger participants (in their late 60s). The findings support the hypothesis that firmness and consistency of beliefs and practices, rather than religiousness per se, buffers against death anxiety in old age.

  17. 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

  18. Where and how people with schizophrenia die: a population-based, matched cohort study in Manitoba, Canada.

    PubMed

    Martens, Patricia J; Chochinov, Harvey M; Prior, Heather J

    2013-06-01

    To compare place and cause of death for people with and without schizophrenia in Manitoba, Canada. By using deidentified administrative databases at the Manitoba Centre for Health Policy, a 1:3 matched cohort of decedents aged ≥ 10 years in fiscal years April 1995-March 2008 (n = 3,943 with schizophrenia; n = 11,827 without schizophrenia) was selected and matched on age, sex, geography, and date of death ± 2 months. Schizophrenia was defined as ICD-9-CM code 295 or ICD-10-CA codes F20, F21, F23.2, or F25 in hospital/physician files at least once within 12 years of death. The median age at death was 77 years. The attributable percentage of deaths was higher for respiratory illnesses (all ages) and suicide (age 10-59 years only), similar for circulatory illnesses, and lower for cancer in decedents with schizophrenia compared to matched controls. For cancer deaths, decedents with schizophrenia were equally likely to die of gastrointestinal, breast, or prostate cancer, but more likely to die of lung cancer at ages 10-59 (32.5% versus 20.6%, P < .004). Place of death was more likely a nursing home (29.7% vs 13.9%) and less likely a hospital (55.5% vs 70.5%) (P < .0001) for decedents with schizophrenia overall and by specific cause, with the exception of suicide deaths showing no difference by place. Except for those who died in nursing homes, decedents with schizophrenia had higher general practitioner but lower specialist rates and inpatient hospital separations. Generally, patients with schizophrenia were more likely to die in nursing homes but less likely to die in hospitals. Understanding where these patients die is critical for improving access to quality palliative end-of-life care. © Copyright 2013 Physicians Postgraduate Press, Inc.

  19. Studying Short-Period Comets and Long-Period Comets Detected by WISE/NEOWISE

    NASA Astrophysics Data System (ADS)

    Kramer, Emily A.; Fernández, Yanga R.; Bauer, James M.; Stevenson, Rachel; Mainzer, Amy K.; Grav, Tommy; Masiero, Joseph; Walker, Russell G.; Lisse, Carey M.

    2014-11-01

    The Wide-field Infrared Survey Explorer (WISE) mission surveyed the sky in four infrared wavelength bands (3.4, 4.6, 12 and 22-micron) between January 2010 and February 2011 [1, 2]. During the mission, WISE serendipitously observed 160 comets, including 21 newly discovered objects. About 89 of the comets observed by WISE displayed a significant dust tail in the 12 and 22-micron (thermal emission) bands, showing a wide range of activity levels and dust morphology. Since the observed objects are a mix of both long-period comets (LPCs) and short-period comets (SPCs), differences in their activity can be used to better understand the thermal evolution that each of these populations has undergone. For the comets that displayed a significant dust tail, we have estimated the sizes and ages of the particles using dynamical models based on the Finson-Probstein method [3, 4]. For a selection of 40 comets, we have then compared these models to the data using a novel tail-fitting method that allows the best-fit model to be chosen analytically rather than subjectively. For comets that were observed multiple times by WISE, the dust tail particle properties were estimated separately, and then compared. We find that the dust tails of both LPCs and SPCs are primarily comprised of ~mm to cm sized particles, which were the result of emission that occurred several months to several years prior to the observations. The LPCs nearly all have strong dust emission close to the comet's perihelion distance, and the SPCs mostly have strong dust emission close to perihelion, but some have strong dust emission well before perihelion. Acknowledgments: This publication makes use of data products from (1) WISE, which is a joint project of UCLA and JPL/Caltech, funded by NASA; and (2) NEOWISE, which is a project of JPL/Caltech, funded by the Planetary Science Division of NASA. EK was supported by a NASA Earth and Space Sciences Fellowship. RS gratefully acknowledges support from the NASA

  20. A Period Study of the Close Binary V508 Ophiuchi

    NASA Astrophysics Data System (ADS)

    Albayrak, Berahitdin

    The short-period (0d.34) close binary V508 Oph was observed in 2005 and four new times of minima were derived. All of the available times of minima, including the new ones, covering 69 years were analyzed. It was shown that the period change of the system is very complex. Two possible period oscillations with periods of 24.73 and 9.91 years and amplitudes of about 0.011 and 0.002 day, respectively, were found to superimpose on upward parabolic change, indicating a secular period increase at a rate of dp/dt = 4.24 × 10-9 days yr-1. The mechanisms that could explain the period changes of the system are discussed.

  1. Ethical dilemmas around the dying patient with stroke: a qualitative interview study with team members on stroke units in Sweden.

    PubMed

    Eriksson, Helene; Andersson, Gisela; Olsson, Louise; Milberg, Anna; Friedrichsen, Maria

    2014-06-01

    In Sweden, individuals affected by severe stroke are treated in specialized stroke units. In these units, patients are attended by a multiprofessional team with a focus on care in the acute phase of stroke, rehabilitation phase, and palliative phase. Caring for patients with such a large variety in condition and symptoms might be an extra challenge for the team. Today, there is a lack of knowledge in team experiences of the dilemmas that appear and the consequences that emerge. Therefore, the purpose of this article was to study ethical dilemmas, different approaches, and what consequences they had among healthcare professionals working with the dying patients with stroke in acute stroke units. Forty-one healthcare professionals working in a stroke team were interviewed either in focus groups or individually. The data were transcribed verbatim and analyzed using content analysis. The ethical dilemmas that appeared were depending on "nondecisions" about palliative care or discontinuation of treatments. The lack of decision made the team members act based on their own individual skills, because of the absence of common communication tools. When a decision was made, the healthcare professionals had "problems holding to the decision." The devised and applied plans could be revalued, which was described as a setback to nondecisions again. The underlying problem and theme was "communication barriers," a consequence related to the absence of common skills and consensus among the value system. This study highlights the importance of palliative care knowledge and skills, even for patients experiencing severe stroke. To make a decision and to hold on to that is a presupposition in creating a credible care plan. However, implementing a common set of values based on palliative care with symptom control and quality of life might minimize the risk of the communication barrier that may arise and increases the ability to create a healthcare that is meaningful and dignified.

  2. The Concept of the Sensitive Period in Developmental Studies.

    ERIC Educational Resources Information Center

    Oyama, Susan

    1979-01-01

    Aims at clarifying the concept of the sensitive period. Differentiates imprinting and sensitivity and defines the latter as an interval of heightened responsiveness to certain kinds of stimuli. Argues that "sensitive period" is a descriptive, not an explanatory term which is consistent with an interactional approach to developmental…

  3. 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.

  4. 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.

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

    PubMed

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

    2016-06-01

    A majority of patients prefer to die at home. Specialist palliative care aims to improve quality of life. Hospice assist at home is a Dutch model of general/specialised palliative care within primary care, collaboratively built by general practitioners and a hospice. The aims of this study are to explore whether hospice assist at home service enables patients at hometo express end-of-life preferences and die in their preferred location. In addition, this study provides insight into symptomburden, stability and early referral. A retrospective cross-sectional evaluation study was performed (December 2014-March 2015), using hospice assist at home patient records and documentation. Primary outcome includes congruence between preferred and actual place of death. Secondary outcomes include symptom burden, (in)stability and early identification. Between June 2012 and December 2014, 130 hospice assist at home patients, living at home with a life expectancy <1 year, were enrolled. Hospice assist at home, a collaboration between general practitioners, district nurses, trained volunteers and a hospice team, facilitates (1) general practitioner-initiated consultation by Nurse Consultant Hospice, (2) fortnightly interdisciplinary consultations and (3) 24/7 hospice backup for patients, caregivers and professionals. A total of 130 patients (62 (48%) men; mean age, 72 years) were enrolled, of whom 107/130 (82%) died and 5 dropped out. Preferred place of death was known for 101/107 (94%) patients of whom 91% patients died at their preferred place of death. Hospice assist at home service supports patients to die in their preferred place of death. Shared responsibility of proactive care in primary care collaboration enabled patients to express preferences. Hospice care should focus on local teamwork, to contribute to shared responsibilities in providing optimal palliative care. © The Author(s) 2016.

  6. 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.

  7. 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.

  8. Evaluation of the Luting Cement Space for Provisional Restoration by using Various Coats of Die Spacer Materials-An Invitro Study.

    PubMed

    Chiramana, Sandeep; Siddineni, Krishna Chaitanya; Jyothula, Ravi Rakesh Dev; Gade, Phani Krishna; Bhupathi, Deepthi; Kondaka, Sudheer; Hussain, Zakir; Paluri, Geetha Bhavani

    2014-09-01

    The present study was to evaluate the space provided for the temporary luting cement, after the application of various coats of die spacers, during the fabrication of provisional crowns and bridges. A total of 50 specimens of dental stone with provisional crowns on all these samples were prepared and were divided into five groups based on the application of various coats of different die spacers. Later these specimens were sectioned buccolingually and were observed using a stereomicroscope under 100X magnification. The images thus obtained were evaluated and noted for the amount of space between the inner surface of the provisional crown and the specimens at five different locations using Image Pro 6.0 Express software and the values were subjected to one-way ANOVA test, and unpaired t-test. There was a significant increase of luting space thickness with various die spacer applications than the specimens of control group. Specimens of double coat applications of silver and gold die spacers showed higher luting cement space than the separating media application specimens.

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

    PubMed Central

    van der Lee, M. L.; Vergouwe, Y.

    2016-01-01

    Background Palliative sedation is the widely-used intervention of administering sedating agents to induce a state of unconsciousness to take away a dying patient’s perception of otherwise irrelievable symptoms. However, it remains questionable whether this ethically complex intervention is beneficial for patients and whether the associated lack of communication in the last phase of life has a negative impact on relatives’ wellbeing. Methods An observational questionnaire study was conducted among relatives of a consecutive sample of patients who died a non-sudden death in the Erasmus MC Cancer Institute or in the hospice ‘Laurens Cadenza’ (both in Rotterdam) between 2010 and 2013. Results Relatives filled in questionnaires regarding 151 patients who had been sedated and 90 patients who had not been sedated. The median time since all patients had passed away was 21 (IQR 14–32) months. No significant differences were found in relatives´ assessments of the quality of end-of-life care, patients´ quality of life in the last week before death and their quality of dying, between patients who did and did not receive sedation, or in relatives’ satisfaction with their own life, their general health and their mental wellbeing after the patient’s death. Conclusions The use of sedation in these patients appears to have no negative effect on bereaved relatives’ evaluation of the patient’s dying phase, or on their own wellbeing after the patient’s death. PMID:26871717

  10. Dying at home of cancer: whose needs are being met? The experience of family carers and healthcare professionals (a multiperspective qualitative study).

    PubMed

    Pottle, Jackie; Hiscock, Julia; Neal, Richard D; Poolman, Marlise

    2017-01-16

    Supporting patients to die in the place of their choosing is an important aspect of end of life care. Our study set out to answer the question: 'How does the home environment influence perceptions of quality of death, and the experience of caring for the dying at home, for family carers and healthcare professionals (HCPs)? A qualitative approach, using multiperspective interviews with bereaved family carers (n=15) and a nominated HCP (n=13) ensured depth of insight gained into supporting a home death. The semistructured interviews were audio recorded, transcribed verbatim and analysed using Framework. We found that the home environment enabled normality, a sense of control and individualised care which family carers often perceived as contributing towards a good death. However, the home environment created challenges for both family carers and HCPs, due to the differing and at times conflicting needs of the dying person and their family carers. We have shed light on the complexity of balancing the demands and the satisfaction of caring for someone dying at home. The ability to manage these conflicting needs influenced whether carers perceived the home setting as the best place for the person to have received care in their last days of life. 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/.

  11. 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.

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

    SciTech Connect

    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 cooling 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 with die

  13. A study of periodic and aperiodic ferromagnetic antidot lattices

    NASA Astrophysics Data System (ADS)

    Bhat, Vinayak S.

    This thesis reports our study of the effect of domain wall pinning by ferromagnetic (FM) metamaterials [1] in the form of periodic antidot lattices (ADL) on spin wave spectra in the reversible regime. This study was then extended to artificial quasicrystals in the form of Penrose P2 tilings (P2T). Our DC magnetization study of these metamaterials showed reproducible and temperature dependent knee anomalies in the hysteretic regime that are due to the isolated switching of the FM segments. Our dumbbell model analysis [2] of simulated magnetization maps indicates that FM switching in P2T is nonstochastic . We have also acquired the first direct, two-dimensional images of the magnetization of Permalloy films patterned into P2T using scanning electron microscopy with polarization analysis (SEMPA). Our SEMPA images demonstrate P2T behave as geometrically frustrated networks of narrow ferromagnetic film segments having near-uniform, bipolar (Ising-like) magnetization, similar to artificial spin ices (ASI). We find the unique aperiodic translational symmetry and diverse vertex coordination of multiply-connected P2T induce a more complex spin-ice behavior driven by exchange interactions in vertex domain walls, which differs markedly from the behavior of disconnected ASI governed only by dipolar interactions. Keywords: Ferromagnetic Antidot Lattices, Metamaterials, Ferromagnetic Resonance, Artificial Quasicrystal, Artificial Spin Ice. [1] VV Kruglyak et al. "Magnonic metamaterials". In: Metamaterial, edited by X.-Y. Jiang (InTech, 2012) (2012). [2] Claudio Castelnovo, Roderich Moessner, and Shivaji L Sondhi. "Magnetic monopoles in spin ice". In: Nature 451.7174 (2008), pp. 42--45.

  14. Place of death in the population dying from diseases indicative of palliative care need: a cross-national population-level study in 14 countries.

    PubMed

    Pivodic, Lara; Pardon, Koen; Morin, Lucas; Addington-Hall, Julia; Miccinesi, Guido; Cardenas-Turanzas, Marylou; Onwuteaka-Philipsen, Bregje; Naylor, Wayne; Ruiz Ramos, Miguel; Van den Block, Lieve; Wilson, Donna M; Loucka, Martin; Csikos, Agnes; Rhee, Yong Joo; Teno, Joan; Deliens, Luc; Houttekier, Dirk; Cohen, Joachim

    2016-01-01

    Studying where people die across countries can serve as an evidence base for health policy on end-of-life care. This study describes the place of death of people who died from diseases indicative of palliative care need in 14 countries, the association of place of death with cause of death, sociodemographic and healthcare availability characteristics in each country and the extent to which these characteristics explain country differences in the place of death. Death certificate data for all deaths in 2008 (age ≥1 year) in Belgium, Canada, the Czech Republic, England, France, Hungary, Italy, Mexico, the Netherlands, New Zealand, South Korea, Spain (Andalusia), the USA and Wales caused by cancer, heart/renal/liver failure, chronic obstructive pulmonary disease, diseases of the nervous system or HIV/AIDS were linked with national or regional healthcare statistics (N=2,220,997). 13% (Canada) to 53% (Mexico) of people died at home and 25% (the Netherlands) to 85% (South Korea) died in hospital. The strength and direction of associations between home death and cause of death, sociodemographic and healthcare availability factors differed between countries. Differences between countries in home versus hospital death were only partly explained by differences in these factors. The large differences between countries in and beyond Europe in the place of death of people in potential need of palliative care are not entirely attributable to sociodemographic characteristics, cause of death or availability of healthcare resources, which suggests that countries' palliative and end-of-life care policies may influence where people die. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. 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.

  16. Periodic quantum chemical studies on anhydrous and hydrated acid clinoptilolite.

    PubMed

    Valdiviés Cruz, Karell; Lam, Anabel; Zicovich-Wilson, Claudio M

    2014-08-07

    Periodic quantum chemistry methods as implemented in the crystal09 code were considered to study acid clinoptilolite (HEU framework type), both anhydrous and hydrated. The most probable location of acid sites and water molecules together with other structural details has been the object of particular attention. Calculations were performed at hybrid and pristine DFT levels of theory with a VDZP quality basis set in order to compare performances. It arises that PBE0 provides the best agreement with experimental data as concerns structural features and the most stable Al distribution in the framework. The role of the water molecule distribution in the stability of the systems, the most probable structure that they induce in the material, and their eventual influence on further chemical modification processes, such as dealumination, are discussed in detail. Results show that, apart from the usually considered interactions of water molecules with the zeolite framework, that is, a H-bond with Brönsted acid sites and coordination with framework Al as Lewis ones, it is necessary to consider cooperation of other weaker effects so as to fully understand the hydration effect in this kind of materials.

  17. CCD Photometric Study and Period Investigation of AH Tauri

    NASA Astrophysics Data System (ADS)

    Xiang, Fu-Yuan; Xiao, Ting-Yu; Yu, Yun-Xia

    2015-07-01

    In this paper, we present new CCD photometric observations of AH Tauri in the R band observed in 2006 at the Yunnan Observatory. Two new times of light minima were derived from these observations. We modeled the light curves using the 2003 version of the Wilson-Devinney program. The results show that the variations of the light curves can be expained by a cool spot on the primary star. The fill-out factor is about 6.6%, indicating that AH Tauri is a shallow-contact system. The mass ratio was determined to be about 0.505. In addition, the orbital period variations of AH Tauri were investigated based on all of the photoelectric and CCD light minimum times, including our two new data. It was found that the orbital period exhibits a possible periodic variation with a period of {P}{mod}=54.62\\(+/- 0.20) years and a secular period decrease of {dP}/{dt}=-(1.823+/- 0.215)× {10}-7 {days} {{yr}}-1. Since AH Tauri is an overcontact solar-like system, we discuss three mechanisms of the mass transfer, the light-time effect of the third body, and magnetic activity responsible for the orbital period changes.

  18. Emily Dickinson revisited: a study of periodicity in her work.

    PubMed

    McDermott, J F

    2001-05-01

    Emily Dickinson, arguably one of America's foremost poets, is characterized by critics as able to capture extreme emotional states in her greatest work. Recent dating of her poems offers the periodicity of her writing as a behavior that can be examined for patterns of affective illness that may relate to these states. The bulk of Dickinson's work was written during a clearly defined 8-year period when she was age 28-35. Poems written during that period, 1858-1865, were grouped by year and examined for annual and seasonal distribution. Her 8-year period of productivity was marked by two 4-year phases. The first shows a seasonal pattern characterized by greater creative output in spring and summer and a lesser output during the fall and winter. This pattern was interrupted by an emotional crisis that marked the beginning of the second phase, a 4-year sustained period of greatly heightened productivity and the emergence of a revolutionary poetic style. These data, supported by excerpts from letters to friends during this period of Dickinson's life, demonstrate seasonal changes in mood during the first four years of major productivity, followed by a sustained elevation of creative energy, mood, and cognition during the second. They suggest, as supported by family history, a bipolar pattern previously described in creative artists.

  19. On death and dying - an exploratory and evaluative study of a reflective, interdisciplinary course element in undergraduate anatomy teaching.

    PubMed

    Alt-Epping, Bernd; Lohse, Constanze; Viebahn, Christoph; Steinbüchel, Nicole von; Benze, Gesine; Nauck, Friedemann

    2014-01-27

    Teaching in palliative care aims not only at providing students with specialized knowledge in symptom therapy in advanced disease, but also at developing a professional attitude consistent with the principles and philosophy of palliative care. Reflecting about one's own or the patient's death and dying is considered essential for empathic patient care. In medical education the dissection course is often the first encounter with the issue of death and dying and represents a significant emotional challenge to many medical students.Against this background we implemented a new course element in preparation for the dissection course, offering opportunity to reflect own experiences with death and dying and providing support in finding a balance between authentic empathy and pragmatic action towards deceased persons. We discuss issues such as dignity and professional distance and reason whether guided support for medical students regarding these issues might influence their future attitude as doctors caring for their patients. In tandem, we performed a formal evaluation of the seminar and explored the students' experiences with death and dying, their expectations and fears in the run-up to the dissection course and their attitude towards dissection. This article describes the structure and the concept of this new interdisciplinary course element and presents the results of the formal course evaluation as well as the explorative part of the accompanying research. Medical students had broad experiences with death and dying even before the dissection course. 89.1% of students had worried about some kind of emotional stress during the dissection course before, but 61.7% stated to have actually perceived emotional stress afterwards. The willingness to donate one's own body for anatomy purposes decreased significantly during the course. The given room for reflection and discussion was appreciated by the students, who felt that the effects of this seminar might be of use even

  20. Quasi-periodic VLF emissions with short-period modulation and their relationship to whistlers: a case study

    NASA Astrophysics Data System (ADS)

    Titova, Elena; Demekhov, Andrei; Kozlovsky, Alexander; Manninen, Jyrki; Pasmanik, Dmitry

    We study properties of quasiperiodic (QP) VLF emissions recorded on December 24, 2011 during the VLF campaign in Northern Finland. The main attention is paid to interrelationships between different characteristic periods in the QP spectra. In particular, we analyze regular variations in the QP repetition intervals (1 - 10 min) during the event from 15:30 to 22 UT, their changes during substorms, and short periodic (several-second) modulation observed within separate QP elements. We explained the variations of periods of QP emissions in terms of the model of auto-oscillation regime of the cyclotron instability in the magnetosphere. During the considered event lasting about 7 hours we observed a regular increase in the time intervals between the QP elements. We relate this increase with weakening of the magnetospheric source of energetic electrons. Significant variations in the QP period occurred during substorms. These variations can be due to a substorm-related increase in the energetic-electron flux and/or due to the precipitation of these electrons into the ionosphere which changes the reflection coefficient of VLF waves. We analyze the fine structure of QP element spectra and reveal the periods related to the time scales of guided propagation of whistler-mode waves along the magnetic field line, which suggests that ducted propagation regime took place for the QP emissions. The periods were about 6--9 s for frequencies 3.5--1.2 kHz respectively, which was similar to the period of almost simultaneously observed two-hop whistlers In the low-frequency part of QP spectra periodic emissions with меньшими periods of about 3 s were observed. Analysis of fine structure of QP elements shows that their formation is affected by both linear effects (i.e., group-velocity dispersion) and nonlinear effects related

  1. Morbidity and mortality in the antiphospholipid syndrome during a 10-year period: a multicentre prospective study of 1000 patients.

    PubMed

    Cervera, R; Serrano, R; Pons-Estel, G J; Ceberio-Hualde, L; Shoenfeld, Y; de Ramón, E; Buonaiuto, V; Jacobsen, S; Zeher, M M; Tarr, T; Tincani, A; Taglietti, M; Theodossiades, G; Nomikou, E; Galeazzi, M; Bellisai, F; Meroni, P L; Derksen, R H W M; de Groot, P G D; Baleva, M; Mosca, M; Bombardieri, S; Houssiau, F; Gris, J-C; Quéré, I; Hachulla, E; Vasconcelos, C; Fernández-Nebro, A; Haro, M; Amoura, Z; Miyara, M; Tektonidou, M; Espinosa, G; Bertolaccini, M L; Khamashta, M A

    2015-06-01

    To assess the prevalence of the main causes of morbi-mortality in the antiphospholipid syndrome (APS) during a 10-year-follow-up period and to compare the frequency of early manifestations with those that appeared later. In 1999, we started an observational study of 1000 APS patients from 13 European countries. All had medical histories documented when entered into the study and were followed prospectively during the ensuing 10 years. 53.1% of the patients had primary APS, 36.2% had APS associated with systemic lupus erythematosus and 10.7% APS associated with other diseases. Thrombotic events appeared in 166 (16.6%) patients during the first 5-year period and in 115 (14.4%) during the second 5-year period. The most common events were strokes, transient ischaemic attacks, deep vein thromboses and pulmonary embolism. 127 (15.5%) women became pregnant (188 pregnancies) and 72.9% of pregnancies succeeded in having one or more live births. The most common obstetric complication was early pregnancy loss (16.5% of the pregnancies). Intrauterine growth restriction (26.3% of the total live births) and prematurity (48.2%) were the most frequent fetal morbidities. 93 (9.3%) patients died and the most frequent causes of death were severe thrombosis (36.5%) and infections (26.9%). Nine (0.9%) cases of catastrophic APS occurred and 5 (55.6%) of them died. The survival probability at 10 years was 90.7%. Patients with APS still develop significant morbidity and mortality despite current treatment. It is imperative to increase the efforts in determining optimal prognostic markers and therapeutic measures to prevent these complications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  2. Is Dying Young Worse than Dying Old?

    ERIC Educational Resources Information Center

    Jecker, Nancy S.; Schneiderman, Lawrence J.

    1994-01-01

    Notes that, in contemporary Western society, people feel death of small child is greater injustice than death of older adult and experience correspondingly greater sorrow, anger, regret, or bitterness when very young person dies. Contrasts these attitudes with those of ancient Greece and shows relevance that different attitudes toward death have…

  3. Is Dying Young Worse than Dying Old?

    ERIC Educational Resources Information Center

    Jecker, Nancy S.; Schneiderman, Lawrence J.

    1994-01-01

    Notes that, in contemporary Western society, people feel death of small child is greater injustice than death of older adult and experience correspondingly greater sorrow, anger, regret, or bitterness when very young person dies. Contrasts these attitudes with those of ancient Greece and shows relevance that different attitudes toward death have…

  4. [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.

  5. [Study on optimal harvest period of Lonicera Flos (Lonicera macranthoides)].

    PubMed

    Li, Long-Yun; Zhang, Ying; Ma, Peng; Wu, Ye-Kuan

    2014-08-01

    To ascertain the optimal harvest period of Lonicera Flos (Lonicera macranthoides) the configuration yield and quality of L. macranthiodes bloom verity and bud verity flower at different develop periods were Observed. The quality of L. macranthiodes which harvested at different times of the day was Compared. The configuration was significant difference between different develop period of L. macranthiodes flower. As bud growth, yield increased. Bloom verity of L. macranthoides chlorogenic acid content was significantly lower after opening (silver flower stage, golden flower stage), before opening (young bud stage, green-white stage) have no significant difference of the quality. Bud verity of L. macranthoides macranthoidin B is significant lower at yellow-white stage, young bud stage and green-white stage have no significant difference of the quality. The chlorogenic acid and isochlorogenic acid A content is significant difference between L. macranthoides harvested at different time of the day. The optimal harvest period of bloom verity is the white stage, picking time for 10:00 before and after 18:00. The optimal harvest period is the green-white stage, picking time is 8:00 before and after 18:00.

  6. Where people die.

    PubMed Central

    Katz, B P; Zdeb, M S; Therriault, G D

    1979-01-01

    Death certificates for 1977 filed with the New York State Department of Health were studied to determine where people died. Data were examined by the location and cause of death and by the age, sex, race, and marital status of the decedent. Comparisons were made with a similar study in which U.S. data were used for 1958 events. Approximately 60 percent of all the 1977 deaths in upstate New York occurred in hospitals; only 27 percent occurred outside an institution. The location of death varied by all the factors studied. Within all age categories, males had a higher percentage of hospital deaths. In those age categories in which nursing home deaths comprised a significant proportion of total deaths, females had a higher percentage of such deaths than males. Differences in the location of death according to its cause reflect the nature of the cause of death, for example, whether it was of sudden onset or the result of chronic disease. Most people do not consider in advance where they might die. The idea that age, sex, and marital status, as well as the more obvious cause, all play a part in the location may seem surprising. Yet all these factors were found to be associated withe location of deaths in upstate New York, and there is no reason to believe that this association does not hold true for the entire nation. More research, however, needs to be done based on more years and other geographic artal stutus may be instructive as to the present state of health resources. PMID:515338

  7. 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.

  8. 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.

  9. 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.

  10. Extrusion die and method

    SciTech Connect

    Lipp, G.D.

    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. 4 figures.

  11. Dying and 'euthanasia'.

    PubMed

    Benatar, S R

    1992-07-01

    Medical progress, secularisation of life, growing acceptance of individual human rights (including the right to refuse medical treatment) and of shared decision-making in medicine have focused public attention on the ways in which life may, and perhaps even ought to, be allowed to end in our complex modern era. Intense and thoughtful bio-ethical debate over many years has 'unpacked' the many different understandings and interpretations of the word euthanasia. The consequent conceptual clarification together with recognition and acknowledgement of psychological implications has facilitated a growing rational consensus on openly accepting the withholding and withdrawing of treatment (under defined conditions) within the realm of sound medical practice. This is clearly distinct from assisted suicide and active euthanasia which are generally considered unacceptable perversions of medical practice. Given the ability to sustain life for prolonged periods, often in a permanent state of unconsciousness, the unrealistic expectations of some medical personnel and the lay public, the severe constraints on health care facilities in South Africa and the totally inadequate allocation of resources for highly effective medical treatments, it is appropriate to re-open public debate on the limits of 'striving officiously to keep alive' and on the distinction between 'allowing to die' and 'killing'. Concern that 'rational' arguments reflect moral decay rather than moral progress keeps the debate open and focuses attention on some 'slippery slope' consequences.

  12. Studies of Long Period Variability in Neutron Star HMXB Systems

    NASA Technical Reports Server (NTRS)

    Heindl, William A.

    1998-01-01

    The purpose of this effort was to investigate the long term, quasi-periodic variability of the X-ray emission from the accreting X-ray pulsars LMC X-4 and SMC X-1. These high mass X-ray binary (HMXB) sources are known to vary in a nearly periodic fashion with cycle lengths of about 30 and 60 days respectively. The prevailing model for such behavior is that it is due to the precession of a tilted accretion disk around the neutron star which is the source of the X-ray emission. As the disk precesses, it periodically obscures the emitting region, resulting in reduced flux as observed at the Earth. The obscuration is not strictly periodic, as the disk precession period changes as the total mass and size of the disk change through variable accretion processes. This model is well established for the long-period variability in the X-ray pulsar Her X-1. With this work, my collaborators and I sought to test whether this model works for LMC X-4 and SMC X-1. Observations with the pointed instruments on the Rossi X-ray Timing Explorer (RXTE) were carried out in order to observe changes in the X-ray spectrum and total flux which were correlated with the long period cycles in these objects. One of the main predictions of the precessing disk model is that the periods of low emission are caused not by changes in the central source, but by increased absorption of that flux as seen at the Earth. Such behavior would be observed in the X-ray spectrum as a relative lack of low energy X-rays (which are more easily absorbed) as compared to high energy X-rays. This is what was observed for SMC X-1, landing strong support to the precessing disk model for this system. For LMC X-1, however, the absorption was consistent with zero at the time of minimum flux. The entire spectrum appeared to be equally reduced. This is not supporting evidence for the model. However, it also does not rule out a precessing disk. If at the time of minimum flux, the intervening disk is so thick that no flux, even

  13. Optical Studies of 20 Longer-Period Cataclysmic Binaries

    NASA Astrophysics Data System (ADS)

    Thorstensen, John R.; Peters, Christopher S.; Skinner, Julie N.

    2010-11-01

    We obtained time-series radial-velocity spectroscopy of 20 cataclysmic variable stars, with the aim of determining orbital periods Porb. All of the stars reported here prove to have Porb > 3.5 h. For 16 of the stars, these are the first available period determinations, and for the remaining four (V709 Cas, AF Cam, V1062 Tau, and RX J2133 + 51), we use new observations to improve the accuracy of previously published periods. Most of the targets are dwarf novae, without notable idiosyncrasies. Of the remainder, three (V709 Cas, V1062 Tau, and RX J2133 + 51) are intermediate polars (DQ Her stars); one (IPHAS 0345) is a secondary-dominated system without known outbursts, similar to LY UMa; one (V1059 Sgr) is an old nova; and two others (V478 Her and V1082 Sgr) are long-period novalike variables. The stars with new periods are IPHAS 0345 (0.314 days) V344 Ori (0.234 days) VZ Sex (0.149 days) NSVS 1057 + 09 (0.376 days) V478 Her (0.629 days) V1059 Sgr (0.286 days) V1082 Sgr (0.868 days) FO Aql (0.217 days) V587 Lyr (0.275 days) V792 Cyg (0.297 days) V795 Cyg (0.181 days) V811 Cyg (0.157 days) V542 Cyg (0.182 days) PQ Aql (0.247 days) V516 Cyg (0.171 days) and VZ Aqr (0.161 days). Noteworthy results on individual stars are as follows. We see no indication of the underlying white dwarf star in V709 Cas, as has been previously claimed; based on the nondetection of the secondary star, we argue that the system is farther away that had been thought and the white dwarf contribution is probably negligible. V478 Her had been classified as an SU UMa-type dwarf nova, but this is incompatible with the long orbital period we find. We report the first secondary-star velocity curve for V1062 Tau. In V542 Cyg, we find a late-type contribution that remains stationary in radial velocity, yet the system is unresolved in a direct image, suggesting that it is a hierarchical triple system. Based on observations obtained at the MDM Observatory, operated by Dartmouth College, Columbia

  14. Radial die-wall pressure as a reliable tool for studying the effect of powder water activity on high speed tableting.

    PubMed

    Abdel-Hamid, Sameh; Betz, Gabriele

    2011-06-15

    The effect of moisture as a function of water activity (Aw) on the compaction process is important to understand particle/water interaction and deformation. Studying powder/moisture interaction under pressure with radial die-wall pressure (RDWP) tool was never done. The aim of our study was to use this tool to study this interaction at high compression pressure and speed. Moreover, the effect of changing ejection cam angle (EA) of the machine on ejection force (EF) was investigated. Also, a new tool for prediction of tablet sticking was proposed. Materials with different deformation behaviors stored at low and high moisture conditions were used. Compaction simulation guided by modeling was applied. High Aw resulted in a low residual die-wall pressure (RDP) for all materials, and a high maximum die-wall pressure (MDP) for plastic materials, p < 0.05. This was due to the lubricating and plasticizing effects of water, respectively. However, microcrystalline cellulose showed capping at high Aw and compaction pressure. By increasing compression pressure at high Aw for all materials, effective fall time (EFT) was increased, p < 0.05, showing tendency for sticking. Increasing EA caused an increase of friction and EF for powders, p < 0.05. RDWP was a useful tool to understand particle/moisture interaction under pressure. Copyright © 2011 Elsevier B.V. All rights reserved.

  15. Periodic limb movement disorder : a clinical and polysomnographic study.

    PubMed

    Dhanuka, A K; Singh, G

    2001-12-01

    Periodic limb movement disorder (PLMD) is one of the commonest neurological disorders and causes significant disability, if left untreated. However, it is rarely diagnosed in clinical practice, probably due to lack of awareness and/or lack of necessary diagnostic facilities. Restless leg syndrome (RLS), aging, pregnancy, uraemia, iron deficiency, polyneuropathy are some of the common causes of secondary PLMD. Clinical presentation, polysomnographic findings and management of six patients of PLMD have been discussed in this report.

  16. Photometric Study of Extreme Long Period Eclipsing Binary 31 CYG

    NASA Astrophysics Data System (ADS)

    Jeong, Jang Hae; Lee, Yong-Sam; Kim, Ho-Il

    1991-12-01

    The UBV light curves of an extreme long period binary star 31 Cyg are made with the observations obtained at Yonsei University Observatory for three seasons from 1988 to 1991 and the RI light curves are also made for one season in 1990-1991. The new combined UBV light curves of 31 Cyg are constructed with YOU's and collected data. A preliminary solution of the light curves of 31 Cygis made using Wilson-Devinney codes.

  17. A mobile hospice nurse teaching team's experience: training care workers in spiritual and existential care for the dying - a qualitative study.

    PubMed

    Tornøe, Kirsten; Danbolt, Lars Johan; Kvigne, Kari; Sørlie, Venke

    2015-09-18

    Nursing home and home care nursing staff must increasingly deal with palliative care challenges, due to cost cutting in specialized health care. Research indicates that a significant number of dying patients long for adequate spiritual and existential care. Several studies show that this is often a source of anxiety for care workers. Teaching care workers to alleviate dying patients' spiritual and existential suffering is therefore important. The aim of this study is to illuminate a pioneering Norwegian mobile hospice nurse teaching team's experience with teaching and training care workers in spiritual and existential care for the dying in nursing homes and home care settings. The team of expert hospice nurses participated in a focus group interview. Data were analyzed using a phenomenological hermeneutical method. The mobile teaching team taught care workers to identify spiritual and existential suffering, initiate existential and spiritual conversations and convey consolation through active presencing and silence. The team members transferred their personal spiritual and existential care knowledge through situated "bedside teaching" and reflective dialogues. "The mobile teaching team perceived that the care workers benefitted from the situated teaching because they observed that care workers became more courageous in addressing dying patients' spiritual and existential suffering. Educational research supports these results. Studies show that efficient workplace teaching schemes allowexpert practitioners to teach staff to integrate several different knowledge forms and skills, applying a holisticknowledge approach. One of the features of workplace learning is that expert nurses are able to guide novices through the complexities of practice. Situated learning is therefore central for becoming proficient. Situated bedside teaching provided by expert mobile hospice nurses may be an efficient way to develop care workers' courage and competency to provide spiritual and

  18. Period Studies of Close Binaries, AO Cam and AW Cam

    NASA Astrophysics Data System (ADS)

    Kim, Chun-Hwey; Han, Won-Yong; Nha, Il-Seong

    1992-06-01

    Photoelectric observations of close binary stars, AO Cam and AW Cam, were made during the 1984 observing season with the 61cm reflector at the Sobaeksan Observatory. One time of primary minimum for AO Cam and three primary epochs for AW Cam were derived from the observation of these two system. Times of minimum light of these two binaries collected from literature were analyzed with a least square fitting method. New improved light elements for AO Cam and AW Cam were determined. The orbital period of AO Cam had been constant from October, 1980(JD 2444520) to February, 1985(JD 2446107). However, one secondary time of minimum(JD 2447864.7879) of AO Cam published recently by Mullis and Faulkner(1991) shows large deviation of about 4.6 minutes (0.d0032) from the one predicted by our new light elements. Future observations of times of minima for this system are needed to test this period change. The orbital period of AW Cam has been constant as P = 0d77134645 for about sixty years from the early 1930's to the present.

  19. Die Kometenmission Rosetta

    NASA Astrophysics Data System (ADS)

    Krüger, Harald

    2016-11-01

    Die Rosetta-Mission ist ein Meilenstein in der Erforschung der Kometen und ihrer Entstehung. Eine der größten üerraschungen war die unregelmäßge hantelförmige Gestalt des Zielkometen 67P/Tschurjumow-Gerassimenko. Er besteht wahrscheinlich aus zwei Einzelkörpern, die durch ihre Schwerkraft aneinander gehalten werden. Seine Oberfläche ist sehr rau und zeigt eine sehr vielf ältige Morphologie, die auf eine Vielzahl von ablaufenden Prozessen hindeutet. Der Kometenkern ist vermutlich auf Gr ößnskalen von mehr als etwa 10 bis 100 Metern homogen, Inhomogenitäten auf kleineren Skalen k nnten f r seine Aktivä t verantwortlich sein. Diese ist auf kleine Gebiete konzentriert, und auch Oberflächenveränderungen, die sich innerhalb von einigen Tagen bis wenigen Wochen abspielen, sind lokal. Im Kometenmaterial wurde eine Vielzahl an organischen Substanzen gemessen, die zum Teil als Schlüsselmoleküle für die Synthese der Grundbausteine des Lebens gelten, wie wir es kennen.

  20. 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…

  1. 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…

  2. Attitudes on Death and Dying.

    ERIC Educational Resources Information Center

    Andrus, Charles E.

    This paper explored attitudes toward death and dying revealed through interviews with members of the clergy, the medical profession, funeral directors, nursing home residents, and selected others. The sampling was small and results are not intended to be representative of the groups to which these people belong. Rather, the study may be used as a…

  3. Attitudes on Death and Dying.

    ERIC Educational Resources Information Center

    Andrus, Charles E.

    This paper explored attitudes toward death and dying revealed through interviews with members of the clergy, the medical profession, funeral directors, nursing home residents, and selected others. The sampling was small and results are not intended to be representative of the groups to which these people belong. Rather, the study may be used as a…

  4. Death, dying, and domination.

    PubMed

    Spindelman, Marc

    2008-06-01

    This Article critiques conventional liberal arguments for the right to die on liberal grounds. It contends that these arguments do not go far enough to recognize and address private, and in particular structural, forms of domination. It presents an alternative that does, which is thus more respectful of true freedom in the context of death and dying, and also more consistent with liberalism. After discussing obstacles to the achievement of a right to die that encompasses freedom from both public and private domination, the Article closes with a significant reform project within bioethics that might help bring it about.

  5. Supporting older people with cancer and life-limiting conditions dying at home: a qualitative study of patient and family caregiver experiences of Hospice at Home care.

    PubMed

    Jack, Barbara A; Mitchell, Tracy K; Cope, Louise C; O'Brien, Mary R

    2016-09-01

    To explore patients' and family caregivers' experiences and perceptions of Hospice at Home care. The public indicate a preference to be cared for and to die at home. This has inherent challenges, with a key factor being the family caregiver. Supporting end-of-life care at home has resulted in the expansion of Hospice at Home services. A wide configuration of services exists with a lack of robust evidence as to what is valued by recipients, particularly those who are older people. A prospective descriptive qualitative study. Recruitment was purposive. Eligible participants were in receipt of Hospice at Home service on at least three occasions and were deemed to have a life expectancy measured in weeks rather than days. Digitally recorded semistructured interviews with 41 participants (16 patients and 25 family caregivers) were undertaken between October 2014 - July 2015. Data were analysed and organized thematically. Several subthemes: 'Talking about'; 'Knowing and Doing'; 'Caring for the Caregivers'; and 'Promoting Choice' contributed to the overall theme of Embracing Holism. A positive impact on emotional, psychological, social and physical well-being was apparent. This study has provided additional insights as to the value of Hospice at Home care where Hospice Nurses are helping to bring Hospice care into the home. This is helping to support older people who are dying and their caregivers, to live as well as possible and facilitate their wish to be cared for and die in their own home. © 2016 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

  6. Distinguishing between those dying suddenly or not suddenly from coronary heart disease: long-term prospective results from the Northwick Park Heart Study

    PubMed Central

    Meade, Tom; Clayton, Tim; Chamberlain, Douglas

    2016-01-01

    Aim To establish whether ECG findings are associated with subsequent risk of sudden death from coronary heart disease (CHD). Methods and results Potential risk factors for CHD were measured at entry to the first Northwick Park Heart Study of 2167 men. ECG findings were coded as high or low risk for CHD according to definitions in the Minnesota code. Sudden or non-sudden deaths were defined as occurring in less than or more than 24 hours, respectively. The only factor independently associated with sudden death among the 262 men dying of CHD was high-risk ECG. Of 184 sudden CHD deaths, 34 men (18.5%) had had high-risk ECGs at entry to the study compared with 5 (6.4%) of 78 men who experienced non-sudden deaths (adjusted OR 3.94 (95% CI 1.33 to 11.67)) (p=0.006). Findings were also compared among all 2167 men, where high-risk ECGs were again associated with sudden death. T-wave changes were the main abnormalities associated with a high risk of sudden death. Conclusions In a group of men who had not previously experienced major episodes of CHD but who subsequently died from it, there was strong evidence that high-risk ECG changes, mainly T-wave abnormalities, differentiated between those who later died sudden deaths and those who survived for >24 hours. PMID:28008355

  7. Die Zeitung der Zukunft

    NASA Astrophysics Data System (ADS)

    Wieser, Christoph; Schaffert, Sebastian

    Schon lange wird spekuliert, wie wir in Zukunft Zeitung lesen werden. Werden wir am Frühstückstisch wie gewohnt in einer Zeitung aus Papier schmökern oder werden wir die Zeitung als biegsame Folie beschrieben mit elektronischer Tinte in Händen halten? Wird die Zeitung mit anderen Medien wie Radio und Fernsehen verschmelzen? Viele Varianten sind denkbar. Heute lässt sich schon ein Trend ablesen: Immer mehr Leser entdecken die Online-Zeitung als Informationsmedium, eine Voraussetzung für die Nutzung neuer Technologien in der Zeitung der Zukunft. In diesem Kapitel stellen wir Entwicklungsmöglichkeiten der Online-Zeitung dar, wie sie im Social Semantic Web möglich werden.

  8. Skin-to-skin care for dying preterm newborns and their parents--a phenomenological study from the perspective of NICU nurses.

    PubMed

    Kymre, Ingjerd G; Bondas, Terese

    2013-09-01

    Consequences of separation between preterm newborns and their parents have been discussed in many aspects, thus skin-to-skin care (SSC) has become common practice in Scandinavian Neonatal Intensive Care Units (NICUs) since the 1980s. The International workshop on Kangaroo Mother Care (KMC), 2009, recommends implementation of continuous KMC as the gold standard pervading all medical and nursing care, based on empirical studies and clinical guidelines and they suggest that KMC may be used during terminal care in agreement with parents. Parents have a strong desire to be near their child and give support and emotional comfort when the condition of the child requires it, and it has been suggested that medical staff expect parents to be with the neonates, and therefore, encourages them to hold the neonate while it is dying. The practice of SSC at the end of life has been under-researched, however. The aim of this study, which is part of a larger study on neonatal nursing care, was to describe the phenomenon of how nurses enact SSC for dying preterm newborns and their parents. A phenomenological reflective life world design. A purposive sample of 18 nurses from three Scandinavian NICUs. The essential meaning of the phenomenon was expressed as strong belief in the urgency of SSC in providing mutual proximity and comfort for dying preterm newborns and their parents. The nurses act upon this belief and upon an engagement in securing the best possible present and future experiences of being close, in which the SSC is understood as a necessary premise in achieving the intended optimal conditions. The findings are elaborated in relation to previous caring and nursing research and phenomenology. Skin-to-skin care for dying preterm newborns and their parents is the preferred caring practice among Scandinavian NICU nurses who consider it of major importance to facilitate proximity and comfort through SSC when the newborn is still alive. The authors suggest this practical

  9. 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.

  10. Periodic trends in bond dissociation energies. A theoretical study.

    PubMed

    Mó, Otilia; Yáñez, Manuel; Eckert-Maksić, Mirjana; Maksić, Zvonimir B; Alkorta, Ibón; Elguero, José

    2005-05-19

    Bond dissociation energies (BDEs) of all possible A-X single bonds involving the first- and second-row atoms, from Li to Cl, where the free valences are saturated by hydrogens, have been estimated through the use of the G3-theory and at the B3LYP/6-311+G(3df,2pd)//B3LYP/6-31G(2df,p) DFT level of theory. BDEs exhibit a periodical behavior. The A-X (A = Li, Be, B, Na, Mg, Al, and Si) BDEs show a steady increase along the first and the second row of the periodic table as a function of the atomic number Z(X). For A-X bonds involving electronegative atoms (A = C, N, O, F, P, S, and Cl) the bond energies achieve a maximum around Z(X) = 5. The same behavior is observed when BDEs are plotted against the electronegativity chi(X) of the atom X. Thus, for A-X bonds (A = Li, Be, B, Na, Mg, Al, Si), the BDEs for a fixed A increases, grosso modo, as the electronegativity differences between X and A increase, with some exceptions, which reflect the differences in the relaxation energies of the radicals produced upon the bond cleavage. A similar trend, albeit less pronounced, is found for single A-X bonds, where A = C, N, O, F, P, S, and Cl. However, there is an additional feature embodied in the enhancement of the strength of the A-boron bonds due to the ability of boron to act as a strong electron acceptor. The trends in bond lengths and charge densities at the bond critical points are in line with the aforementioned behavior.

  11. Intensive care at the end of life in patients dying due to non-cancer chronic diseases versus cancer: a nationwide study in Denmark.

    PubMed

    Lyngaa, Thomas; Christiansen, Christian Fynbo; Nielsen, Henrik; Neergaard, Mette Asbjørn; Jensen, Anders Bonde; Laut, Kristina Grønborg; Johnsen, Søren Paaske

    2015-11-24

    It is unknown to what extent use of palliative care and focus on proactive planning of end-of-life (EOL) care among cancer patients is also reflected by less use of intensive care. We aimed to examine the use of intensive care in the EOL in patients dying as a result of non-cancer diseases compared with patients dying due to cancer. We conducted a nationwide follow-up study among 240,757 adults dying as a result of either non-cancer chronic disease or cancer in Denmark between 2005 and 2011. Using the Danish Intensive Care Database, we identified all admissions and treatments in intensive care units (ICU) during the patients' last 6 months before death. We used prevalence ratios (aPRs) adjusted for age, sex, comorbidity, marital status and residential region to compare the 6-month prevalence of ICU admissions as well as treatment with invasive mechanical ventilation (MV), non-invasive ventilation (NIV), renal replacement therapy (RRT) and inotropes and/or vasopressors. In addition, length of ICU stay and death during ICU admission were compared among non-cancer and cancer patients dying between 2009 and 2011. Overall 12.3 % of non-cancer patients were admitted to an ICU within their last 6 months of life, compared with 8.7 % of cancer patients. The overall aPR for ICU admission was 2.11 [95 % confidence interval (CI) 1.98-2.24] for non-cancer patients compared with cancer patients and varied widely within the non-cancer patients (patients with dementia, aPR 0.19, 95 % CI 0.17-0.21; patients with chronic obstructive lung disease, aPR 3.19, 95 % CI 2.97-3.41). The overall aPRs for treatment among non-cancer patients compared with cancer patients were 1.40 (95 % CI 1.35-1.46) for MV, 1.62 (95 % CI 1.50-1.76) for NIV, 1.19 (95 % CI 1.07-1.31) for RRT and 1.05 (95 % CI 0.87-1.28) for inotropes and/or vasopressors. No difference in admission length was observed. Non-cancer patients had an increased risk of dying in an ICU (aPR 1.23, 95 % CI 0.99-1.54) compared with

  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. Adapt or die?

    PubMed

    Visser, S S; Nel, A H

    1996-12-01

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

  14. [The special requirements of old age in terms of dying].

    PubMed

    Kruse, Andreas

    2017-01-01

    It is expected that the rising average life expectancy will leave ever more people with chronic progressive diseases of the body and brain. This then means not only having to deal with increasingly longer periods of care, but also possibly distinct neurocognitive disorders in the years prior to death and dying. The aim of this study is to report epidemiological data on the causes of death, as well as on the places of death. In addition, the attitudes and behaviour towards death and dying, as well as the different places of death will be discussed. Expecting support in the process of dying, as well as factors that have a more conducive effect on the internal processing of dying, are mentioned. At the same time, the attitudes and behaviours in respect of the accompaniment of dying people, which can be seen in the staff in clinical inpatient facilities, are addressed. Personal intense grappling with dying and death actually has a positive effect on these behaviours and attitudes. Finally, the contribution turns to the question of to what extent the theory of compression of morbidity may be perceived as valid, especially in view of the rising average life expectancy. It is emphasised that chronic diseases, even when no functional loss is present, place not only great demands on the patient, but also on the care system and financial resources. Furthermore, it is demonstrated that frailty can often cause mental disorders. Specific requirements with a view to the care of people with dementia are given.

  15. Die einzelnen Beanspruchungsarten

    NASA Astrophysics Data System (ADS)

    Böge, Gert; Böge, Wolfgang

    Wird ein Stab mit beliebigem, gleichbleibendem Querschnitt durch die äußere Kraft F in der Schwerachse auf Zug oder Druck beansprucht, so wird bei gleichmäßiger Spannungsverteilung, also in genügender Entfernung vom Angriffspunkt der Kraft, die Zug- oder Druckspannung σ_{z,d}= Zug- oder Druckkraft F/Querschnittsfläche A {Zug- und Druck-Hauptgleichung} σ_{z,d}=F/A\\qquad σ&F&A N/mm2 & N&mm2 Je nach vorliegender Aufgabe kann die Hauptgleichung umgestellt werden zur Berechnung des erforderlichen Querschnitts (Querschnittsnachweis): A_{erf}=F/σ_{zul} Berechnung der vorhandenen Spannung (Spannungsnachweis): σ_{vorh}=F/A Berechnung der maximal zulässigen Belastung (Belastungsnachweis): F_{max}=σ_{zul}A Treten Zug- und Druckspannungen in einer Rechnung gleichzeitig auf, werden sie durch den Index z und d oder durch das Vorzeichen + und - unterschieden.

  16. Emergencies and outcome in invasive out-of-hospital ventilation: An observational study over a 1-year period.

    PubMed

    Stieglitz, Sven; Matthes, Sandhya; Kietzmann, Ilona; Priegnitz, Christina; Hagmeyer, Lars; Randerath, Winfried

    2017-08-04

    The number of ventilated patients is further increasing which leads to an increasing number of patients with weaning failure. In Germany, the treatment of patients with invasive out-of-hospital becomes more and more common. The aim of the study was to observe the outcome, the frequency and character of emergencies of patients with invasive out-of-hospital ventilation. We conducted a prospective study over 1 year. Fifty-nine invasively ventilated patients living either at home or at nursing homes specialized in ventilator medicine were included. Forty-one (71%) of the patients were living in a nursing home. Chronic obstructive pulmonary disease (COPD) was the most common underlying disease (52.5%). Duration of daily ventilation did not change over the 1-year period. 52.8% of the months went without a documented emergency. The most common emergencies were oxygen desaturation (29.6%), increase of secretion (12.2%) and dyspnea (8.7%). We found no difference in the frequency of emergencies between patients cared for in their own home compared with residential care. Ten patients died during the observation period. Fewer emergencies (P = .02, CI 0.03-0.85) was the only parameter associated with a reduced mortality. Frequency of emergencies as well as survival showed no difference regarding the way patients were cared for. In patients with invasive home mechanical ventilation survival for more than 1 year seems to be common. Only the rate of emergencies affected survival. © 2017 John Wiley & Sons Ltd.

  17. Assisted Dying in Canada.

    PubMed

    Schuklenk, Udo

    2014-01-01

    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.

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

    2014-01-01

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

  20. Comparative study of intravenous opioid consumption in the postoperative period.

    PubMed

    Saracoglu, Kemal Tolga; Saracoglu, Ayten; Cakar, Kubra; Fidan, Vural; Ay, Binnaz

    2012-03-01

    Intravenous patient-controlled analgesia (IV PCA) using opiods is an accepted method for delivering postoperative analgesia. The aim of this study was to compare fentanyl and tramadol with IV PCA after spinal anesthesia (SA) and general anesthesia (GA) following cesarean section (C/S). Ninety women were randomly assigned to three groups (n=30). Group 1 was treated with IV fentanyl PCA after SA. Groups 2 and 3 were treated with IV fentanyl PCA and IV tramadol PCA after GA. Outcome measures were recorded for the first 24 h post-anesthesia. PCA use was significantly lower after SA (P<0.05). Eighteen patients in the SA Group and 27 patients and 24 patients from the GA groups required additional opioid. Opioid consumption and patient satisfaction were similar for groups after GA (P>0.05). 638.4 ± 179.1 μg fentanyl was consumed by patients of Group 2, 356.3 ± 87.0 μg fentanyl and 559.5 ± 207.0 mg tramadol was consumed by Group 1 and Group 3 respectively. There was no significant difference in the overall severity and incidence of nausea, drowsiness or pruritus. Our study shows that analgesic consumption and post-operative pain scores after SA in C/S decreased, without increase in adverse reactions.

  1. Living and dying with dignity: a qualitative study of the views of older people in nursing homes.

    PubMed

    Hall, Sue; Longhurst, Susan; Higginson, Irene

    2009-07-01

    most older people living in nursing homes die there. An empirically based model of dignity has been developed, which forms the basis of a brief psychotherapy to help promote dignity and reduce distress at the end of life. to explore the generalisability of the dignity model to older people in nursing homes. qualitative interviews were used to explore views on maintaining dignity of 18 residents of nursing homes. A qualitative descriptive approach was used. The analysis was both deductive (arising from the dignity model) and inductive (arising from participants' views). the main categories of the dignity model were broadly supported: illness-related concerns, social aspects of the illness experience and dignity conserving repertoire. However, subthemes relating to death were not supported and two new themes emerged. Some residents saw their symptoms and loss of function as due to old age rather than illness. Although residents did not appear to experience distress due to thoughts of impending death, they were distressed by the multiple losses they had experienced. these findings add to our understanding of the concerns of older people in care homes on maintaining dignity and suggest that dignity therapy may bolster their sense of dignity.

  2. Formation of blade and slot die coated small molecule multilayers for OLED applications studied theoretically and by XPS depth profiling

    SciTech Connect

    Peters, Katharina; Raupp, Sebastian Scharfer, Philip; Schabel, Wilhelm; Hummel, Helga; Bruns, Michael

    2016-06-15

    Slot die coaters especially designed for low material consumption and doctor blades were used to process small molecule solutions for organic light-emitting diodes (OLEDs). Optimum process parameters were developed for the large-scale coating techniques to generate stable single and multiple layers only a few nanometers thick. Achieving a multilayer architecture for solution-processed OLEDs is the most challenging step. X-ray photoelectron spectroscopy sputter depth profiling was performed to determine defined interfaces between coated organic layers. Commercially available small molecules NPB (N,N’-Di(1-naphthyl)-N,N’-diphenyl-(1,1’-biphenyl)-4,4’-diamine) and BAlq (Bis(8-hdroxy-2methylquinoline)-(4-phenylphenoxy)aluminum), originally developed for vacuum deposition, were used as hole, respectively electron transport material. Defined double-layers were processed with both scalable coating methods using the orthogonal solvent approach. The use of non-orthogonal solvents resulted in complete intermixing of the material. The results are explained by calculations of solubilities and simulating drying and diffusion kinetics of the small molecule solutions.

  3. Formation of blade and slot die coated small molecule multilayers for OLED applications studied theoretically and by XPS depth profiling

    NASA Astrophysics Data System (ADS)

    Peters, Katharina; Raupp, Sebastian; Hummel, Helga; Bruns, Michael; Scharfer, Philip; Schabel, Wilhelm

    2016-06-01

    Slot die coaters especially designed for low material consumption and doctor blades were used to process small molecule solutions for organic light-emitting diodes (OLEDs). Optimum process parameters were developed for the large-scale coating techniques to generate stable single and multiple layers only a few nanometers thick. Achieving a multilayer architecture for solution-processed OLEDs is the most challenging step. X-ray photoelectron spectroscopy sputter depth profiling was performed to determine defined interfaces between coated organic layers. Commercially available small molecules NPB (N,N'-Di(1-naphthyl)-N,N'-diphenyl-(1,1'-biphenyl)-4,4'-diamine) and BAlq (Bis(8-hdroxy-2methylquinoline)-(4-phenylphenoxy)aluminum), originally developed for vacuum deposition, were used as hole, respectively electron transport material. Defined double-layers were processed with both scalable coating methods using the orthogonal solvent approach. The use of non-orthogonal solvents resulted in complete intermixing of the material. The results are explained by calculations of solubilities and simulating drying and diffusion kinetics of the small molecule solutions.

  4. Ultrasonic real-time in-die monitoring of the tablet compaction process-a proof of concept study.

    PubMed

    Stephens, James D; Kowalczyk, Brian R; Hancock, Bruno C; Kaul, Goldi; Cetinkaya, Cetin

    2013-02-14

    The mechanical properties of a drug tablet can affect its performance (e.g., dissolution profile and its physical robustness. An ultrasonic system for real-time in-die tablet mechanical property monitoring during compaction has been demonstrated. The reported set-up is a proof of concept compaction monitoring system which includes an ultrasonic transducer mounted inside the upper punch of the compaction apparatus. This upper punch is utilized to acquire ultrasonic pressure wave phase velocity waveforms and extract the time-of-flight of pressure waves travelling within the compact at a number of compaction force levels during compaction. The reflection coefficients for the waves reflecting from punch tip-powder bed interface are extracted from the acquired waveforms. The reflection coefficient decreases with an increase in compaction force, indicating solidification. The data acquisition methods give an average apparent Young's moduli in the range of 8-20 GPa extracted during the compaction and release/decompression phases in real-time. A monitoring system employing such methods is capable of determining material properties and the integrity of the tablet during compaction. As compared to the millisecond time-scale dwell time of a typical commercial compaction press, the micro-second pulse duration and ToF of an acoustic pulse are sufficiently fast for real-time monitoring.

  5. The prevalence and drug sensitivity of tuberculosis among patients dying in hospital in KwaZulu-Natal, South Africa: a postmortem study.

    PubMed

    Cohen, Ted; Murray, Megan; Wallengren, Kristina; Alvarez, Gonzalo G; Samuel, Elizabeth Y; Wilson, Douglas

    2010-06-22

    Tuberculosis is the leading cause of death in South Africa by death notification, but accurate diagnosis of tuberculosis is challenging in this setting of high HIV prevalence. We conducted limited autopsies on young adults dying in a single public hospital in the province of KwaZulu-Natal between October 2008 and August 2009 in order to estimate the magnitude of deaths attributable to tuberculosis. We studied a representative sample of 240 adult inpatients (aged 20-45 years) dying after admission to Edendale Hospital. Limited autopsies included collection of respiratory tract secretions and tissue by needle core biopsies of lung, liver, and spleen. Specimens were examined by fluorescent microscopy for acid-fast bacilli and cultured in liquid media; cultures positive for M. tuberculosis were tested for drug susceptibility to first- and second-line antibiotics. Ninety-four percent of our study cohort was HIV seropositive and 50% of decedents had culture-positive tuberculosis at the time of death. Fifty percent of the participants were on treatment for tuberculosis at the time of death and 58% of these treated individuals remained culture positive at the time of death. Of the 50% not receiving tuberculosis treatment, 42% were culture positive. Seventeen percent of all positive cultures were resistant to both isoniazid and rifampin (i.e., multidrug resistant); 16% of patients dying during the initiation phase of their first ever course of tuberculosis treatment were infected with multidrug-resistant bacilli. Our findings reveal the immense toll of tuberculosis among HIV-positive individuals in KwaZulu-Natal. The majority of decedents who remained culture positive despite receiving tuberculosis treatment were infected with pan-susceptible M. tuberculosis, suggesting that the diagnosis of tuberculosis was made too late to alter the fatal course of the infection. There is also a significant burden of undetected multidrug-resistant tuberculosis among HIV

  6. The Prevalence and Drug Sensitivity of Tuberculosis among Patients Dying in Hospital in KwaZulu-Natal, South Africa: A Postmortem Study

    PubMed Central

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

    2010-01-01

    Background Tuberculosis is the leading cause of death in South Africa by death notification, but accurate diagnosis of tuberculosis is challenging in this setting of high HIV prevalence. We conducted limited autopsies on young adults dying in a single public hospital in the province of KwaZulu-Natal between October 2008 and August 2009 in order to estimate the magnitude of deaths attributable to tuberculosis. Methods and Findings We studied a representative sample of 240 adult inpatients (aged 20–45 years) dying after admission to Edendale Hospital. Limited autopsies included collection of respiratory tract secretions and tissue by needle core biopsies of lung, liver, and spleen. Specimens were examined by fluorescent microscopy for acid-fast bacilli and cultured in liquid media; cultures positive for M. tuberculosis were tested for drug susceptibility to first- and second-line antibiotics. Ninety-four percent of our study cohort was HIV seropositive and 50% of decedents had culture-positive tuberculosis at the time of death. Fifty percent of the participants were on treatment for tuberculosis at the time of death and 58% of these treated individuals remained culture positive at the time of death. Of the 50% not receiving tuberculosis treatment, 42% were culture positive. Seventeen percent of all positive cultures were resistant to both isoniazid and rifampin (i.e., multidrug resistant); 16% of patients dying during the initiation phase of their first ever course of tuberculosis treatment were infected with multidrug-resistant bacilli. Conclusions Our findings reveal the immense toll of tuberculosis among HIV-positive individuals in KwaZulu-Natal. The majority of decedents who remained culture positive despite receiving tuberculosis treatment were infected with pan-susceptible M. tuberculosis, suggesting that the diagnosis of tuberculosis was made too late to alter the fatal course of the infection. There is also a significant burden of undetected multidrug

  7. A study of lightning flashes attending periods of banded snowfall

    NASA Astrophysics Data System (ADS)

    Market, Patrick S.; Becker, Amy E.

    2009-01-01

    Lightning flashes (N = 1088) associated with 24 thundersnow events in the central United States were analyzed to document flash polarity, signal strength, and multiplicity. Negative lightning flashes (N = 872; 80%) dominated positive flashes (N = 216; 20%) with wintry precipitation in this study, which stands in contrast to the majority of the research done on winter thunderstorms (primarily in Japan). Otherwise, limited work has been done, although thundersnow has been documented in the mid-latitudes of North America, Europe and Asia. Statistics on peak amplitude were determined for negative (positive) flashes, yielding mean and standard deviation values of -24 kA +/- 22 kA (+38 kA +/- 34 kA). A subset of winter lightning events (N = 16) were then sought that occurred with banded (single or multiple) snowfall, as banding often denotes greater organization in the atmosphere (e.g., a jet streak aloft to aid in ascent, or a low level jet streak to aid with moisture and thermal transport) and thus the potential for deeper snow totals. Radar reflectivity values were recorded at the location of each lightning flash, as well as the maximum radar reflectivity within the associated snow band. The location of the lightning activity within the snow band was also noted as being either leading edge (LE), trailing edge (TE), core (C), or not correlated (NC), with respect to the motion of the parent band. The majority of lightning flashes were found downstream of areas of highest radar reflectivity with respect to the motion of the snow bands, and not with the highest reflectivity values. If one uses the highest reflectivity values in a snowband as a proxy for the greatest surface snowfall intensity, then the ground terminus of a cloud-to-ground lightning (CG) flash is often not co-located with the heaviest snowfall rates. However, the work completed here does place the location of the typical CG flash ~15 km downstream of the snowband location, so one could use the occurrence

  8. Awareness of dying: it needs words.

    PubMed

    Lokker, Martine E; van Zuylen, Lia; Veerbeek, Laetitia; van der Rijt, Carin C D; van der Heide, Agnes

    2012-06-01

    The purpose of this research is to study to what extent dying patients are aware of the imminence of death, whether such awareness is associated with patient characteristics, symptoms and acceptance of dying, and whether medical records and nurses' and family caregivers' views on patients' awareness of dying agree. Nurses and family caregivers of 475 deceased patients from three different care settings in the southwest Netherlands were requested to fill out questionnaires. The two groups were asked whether a patient had been aware of the imminence of death. Also, medical records were screened for statements indicating that the patient had been informed of the imminence of death. Nurses completed questionnaires about 472 patients, family caregivers about 280 patients (response 59%). According to the medical records, 51% of patients had been aware of the imminence of death; according to nurses, 58%; according to family caregivers, 62%. Patients who, according to their family caregiver, had been aware of the imminence of death were significantly more often in peace with dying and felt more often that life had been worth living. Inter-rater agreement on patients' awareness of dying was fair (Cohen's kappa = 0.23-0.31). Being aware of dying is associated with acceptance of dying, which supports the idea that open communication in the dying phase can contribute to the quality of the dying process. However, views on whether or not patients are aware of the imminence of death diverge between different caregivers. This suggests that communication in the dying phase of patients is open for improvement.

  9. [Anguish about death and fear of dying, supportive care for the dying].

    PubMed

    Bouregba, A; Lebret, T

    2008-11-01

    During metastatic patient follow up, anguish about death is different from the fear of dying. In fact anguish is unconscious and associated with anxiety, on the other hand the fear of dying is a reaction to the threat of imminent death. Physical pain and isolation are factors that increase the pangs of death. The support of friends and family constitutes a real benefit for the treatment of patients during this period.

  10. Adolescents’ Perceived Risk of Dying

    PubMed Central

    Fischhoff, Baruch; de Bruin, Wändi Bruine; Parker, Andrew M.; Millstein, Susan G.; Halpern-Felsher, Bonnie L.

    2009-01-01

    Purpose Although adolescents’ expectations are accurate or moderately optimistic for many significant life events, they greatly overestimate their chances of dying soon. We examine here whether adolescents’ mortality judgments are correlated with their perceptions of direct threats to their survival. Such sensitivity would indicate the importance of ensuring that adolescents have accurate information about those threats, as well as the psychological support needed to deal with them. Methods Data from two separate studies were used: a national study of 3,436 14–18 year old adolescents and a regional sample of 124 7th graders and 132 9th graders, 12–16 years old. Participants were asked about their chance of dying in the next year and before age 20, and about the extent of various threats to their physical well being. Results Adolescents in both samples greatly overestimated their chance of dying. Those mortality estimates were higher for adolescents who reported direct threats (e.g., an unsafe neighborhood). Thus, adolescents were sensitive to the relative size of threats to their survival, but not to the implications for absolute risk levels. Conclusions Contrary to the folk wisdom that adolescents have a unique sense of invulnerability, those studied here reported an exaggerated sense of mortality, which was highest among those reporting greater threats in their lives. Such fears could affect adolescents’ short-term well being and future planning. PMID:20159504

  11. When Somebody Dies

    MedlinePlus

    ... to have fun with. That absence leaves a big hole in our lives. Maybe you had a pet that died . Remember the first few times you walked into the house after your dog or cat was gone? It was strange not to have ...

  12. 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…

  13. Die Kosmologie der Griechen.

    NASA Astrophysics Data System (ADS)

    Mittelstraß, J.

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

  14. Poetry and the Dying.

    ERIC Educational Resources Information Center

    Kramer, Aaron

    1992-01-01

    Demonstrates roles poetry can play as people confront the death of loved ones and their own dying. Gives examples of Heinrich Heine transforming his agony into art and, from the poetry of two college students, both in advanced stages of neurological disease, which was read aloud in class, teaching all present something about how to approach their…

  15. When a Student Dies.

    ERIC Educational Resources Information Center

    Dowling-Sendor, Benjamin

    1998-01-01

    A student athlete died after the first day of football practice in Texas. His parents brought suit (Roventini v. Pasadena Independent School District) for monetary damages in federal district court contending that the defendants violated the student's rights. Presents the judge's analysis of the legal issues. Advises board members and…

  16. 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…

  17. Dying in hospital.

    PubMed

    Pearce, Lynne

    2016-06-22

    While surveys consistently show that about two thirds of people want to die at home, more than half of all deaths happen in hospitals. And in their last days, many people are cared for by generalist nursing staff who may be reticent, or even afraid, to talk about what is happening.

  18. When Somebody Dies

    MedlinePlus

    ... container is gone, but what's inside — the water — remains. The part of a person that's left after the body dies is often called the "soul" or "spirit." Some people believe the soul is the part of a human that loves, feels, and creates; it's the part ...

  19. Caring for dying people in hospital.

    PubMed

    Hopkinson, Jane B; Hallett, Christine E; Luker, Karen A

    2003-12-01

    Fifty-four per cent of people who die in England and Wales do so in hospital. Evidence suggests that care delivered to dying people in hospital does not match up to the ideal of a good death. These studies have provided organizational and structural explanations of nurses' behaviour that support argument for change at the macro level, in order to improve the quality of care delivered to dying people. There has been little study of the perceptions of nurses working in acute medical settings in relation to their experience of caring for dying people. Therefore, there is little evidence on which to base supportive strategies at the level of individual nurses. In this study we set out to develop an understanding of care for dying people in hospital, from the perspective of newly qualified staff nurses in the UK. The purpose was to build a theory of how nurses might be helped to deliver quality care to dying people in hospital. This paper is based on an exploratory study underpinned by phenomenological philosophy. In-depth interviews were conducted with 28 newly qualified nurses, focusing on their experiences of caring for dying people on medical wards in two acute hospitals in England in 1999. The interview transcripts were interpreted using a phenomenological approach. The findings presented in this paper relate to commonalities found to underlie study participants' perceptions of their experiences. All the nurses' stories were found to be built around six essences - the personal ideal, the actual, the unknown, the alone, tension and anti-tension. These essences, and the relationships between them, were used to build a model of the experience of caring for dying people in hospital. This descriptive study of the experience of individual nurses does not examine the wider social context. It attempts to complement existing sociological theory of death and dying. The study revealed how a group of newly qualified nurses experienced caring for dying people. We theorize that

  20. 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.

  1. Periodical Utilization Study: Saint Elizabeth Hospital Medical Center, School of Nursing Library, Youngstown, Ohio.

    ERIC Educational Resources Information Center

    Ryan, Holly

    The Saint Elizabeth Hospital Medical Center School of Nursing Library has a strong collection of nursing and nursing management journals. With the rising subscription costs of periodicals, it was necessary to evaluate the collection of periodicals. This study was done to evaluate the periodicals that the library has in paper form. The study…

  2. Rationalization of Periodical Holdings: A Case Study at Chalmers University Library.

    ERIC Educational Resources Information Center

    Fjallbrant, Nancy

    1984-01-01

    Describes study of periodical use in medium-sized university of technology which examined use of individual periodicals in relation to language of publication; patterns of use for interlibrary lending and for multiple copy journals; methods and costs for acquiring infrequently used periodicals. Thirty-three references and most frequently used…

  3. A comparison of the accuracy of three removable die systems and two die materials.

    PubMed

    Sivakumar, I; Mohan, J; Arunachalam, K S; Zankari, V

    2013-09-01

    The purpose of this study was to evaluate the dimensional shift of three commonly used die systems (Conventional system, Pindex system, Di-Lok tray system) with two commercially available type IV die stones (Ultra rock and Pearl stone). Under controlled conditions, ten casts, each with two removable dies, were constructed for each system for a total of 30 casts and 60 removable dies. Before and after sectioning measurements to within 0.01 mm in horizontal and vertical planes were recorded and differences calculated. Data were analyzed with 't' tests, one way analysis of variance and post hoc Tukey test. The results demonstrated that among the die systems compared, no single system was superior to the others in all respects. But among the die materials, dies poured in Pearl stone exhibited more dimensional changes than Ultra rock (p<0.05). Selection of die material is as critical as selection of any particular die system for successful fabrication of fixed partial denture and implant prosthesis.

  4. Exploring hereditary cancer among dying cancer patients--a cross-sectional study of hereditary risk and perceived awareness of DNA testing and banking.

    PubMed

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

    2010-10-01

    Hereditary cancer assessment at the end of life is a relatively unexplored area, but it could be critical for surviving family members. This study explored the prevalence of hereditary cancer among dying cancer patients and assessed patients' perceived awareness of DNA testing and/or banking in a public access hospital. Palliative care patients with cancer from a single institution (or their medical-decision-making surrogates for patients unable to answer for themselves) completed structured interviews. Information was collected through medical records review and structured interviews for 43 dying cancer patients. Information for 9 patients was collected from surrogates. Nine patients (21%, 95% CI = 8.8% to 33.1%) had strong genetic risk. Currently available genetic tests could have addressed this risk for several patients. None had previous genetic counseling, testing or DNA banking. Among strong-risk patients, about half of patients/surrogates had heard/read "almost nothing" about genetic testing (44%) and DNA banking (67%). Perceived genetic awareness was not associated with genetic risk, and neither were sociodemographic characteristics. The proportion of hereditary cancer may be at least as high in the palliative care population as in other clinical settings, but awareness and uptake among patients are low. These conditions are not being recognized upstream and families are losing valuable information.

  5. 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.

  6. Transferring patients home to die: what is the potential population in UK critical care units?

    PubMed

    Coombs, Maureen A; Darlington, Anne-Sophie E; Long-Sutehall, Tracy; Pattison, Natalie; Richardson, Alison

    2017-03-01

    Most people when asked, express a preference to die at home, but little is known about whether this is an option for critically ill patients. A retrospective cohort study was undertaken to describe the size and characteristics of the critical care population who could potentially be transferred home to die if they expressed such a wish. Medical notes of all patients who died in, or within 5 days of discharge from seven critical care units across two hospital sites over a 12-month period were reviewed. Inclusion/exclusion criteria were developed and applied to identify the number of patients who had potential to be transferred home to die and demographic and clinical data (eg, conscious state, respiratory and cardiac support therapies) collected. 7844 patients were admitted over a 12-month period. 422 (5.4%) patients died. Using the criteria developed 100 (23.7%) patients could have potentially been transferred home to die. Of these 41 (41%) patients were diagnosed with respiratory disease. 53 (53%) patients were conscious, 47 (47%) patients were self-ventilating breathing room air/oxygen via a mask. 20 (20%) patients were ventilated via an endotracheal tube. 76 (76%) patients were not requiring inotropes/vasopressors. Mean time between discussion about treatment withdrawal and time of death was 36.4 h (SD=46.48). No patients in this cohort were transferred home. A little over 20% of patients dying in critical care demonstrate potential to be transferred home to die. Staff should actively consider the practice of transferring home as an option for care at end of life for these patients. 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/.

  7. Transferring patients home to die: what is the potential population in UK critical care units?

    PubMed Central

    Coombs, Maureen A; Darlington, Anne-Sophie E; Long-Sutehall, Tracy; Pattison, Natalie; Richardson, Alison

    2017-01-01

    Objectives Most people when asked, express a preference to die at home, but little is known about whether this is an option for critically ill patients. A retrospective cohort study was undertaken to describe the size and characteristics of the critical care population who could potentially be transferred home to die if they expressed such a wish. Methods Medical notes of all patients who died in, or within 5 days of discharge from seven critical care units across two hospital sites over a 12-month period were reviewed. Inclusion/exclusion criteria were developed and applied to identify the number of patients who had potential to be transferred home to die and demographic and clinical data (eg, conscious state, respiratory and cardiac support therapies) collected. Results 7844 patients were admitted over a 12-month period. 422 (5.4%) patients died. Using the criteria developed 100 (23.7%) patients could have potentially been transferred home to die. Of these 41 (41%) patients were diagnosed with respiratory disease. 53 (53%) patients were conscious, 47 (47%) patients were self-ventilating breathing room air/oxygen via a mask. 20 (20%) patients were ventilated via an endotracheal tube. 76 (76%) patients were not requiring inotropes/vasopressors. Mean time between discussion about treatment withdrawal and time of death was 36.4 h (SD=46.48). No patients in this cohort were transferred home. Conclusions A little over 20% of patients dying in critical care demonstrate potential to be transferred home to die. Staff should actively consider the practice of transferring home as an option for care at end of life for these patients. PMID:26628534

  8. Verbal autopsy as a tool for identifying children dying of sickle cell disease: a validation study conducted in Kilifi district, Kenya

    PubMed Central

    2014-01-01

    Background Sickle cell disease (SCD) is common in many parts of sub-Saharan Africa (SSA), where it is associated with high early mortality. In the absence of newborn screening, most deaths among children with SCD go unrecognized and unrecorded. As a result, SCD does not receive the attention it deserves as a leading cause of death among children in SSA. In the current study, we explored the potential utility of verbal autopsy (VA) as a tool for attributing underlying cause of death (COD) in children to SCD. Methods We used the 2007 WHO Sample Vital Registration with Verbal Autopsy (SAVVY) VA tool to determine COD among child residents of the Kilifi Health and Demographic Surveillance System (KHDSS), Kenya, who died between January 2008 and April 2011. VAs were coded both by physician review (physician coded verbal autopsy, PCVA) using COD categories based on the WHO International Classification of Diseases 10th Edition (ICD-10) and by using the InterVA-4 probabilistic model after extracting data according to the 2012 WHO VA standard. Both of these methods were validated against one of two gold standards: hospital ICD-10 physician-assigned COD for children who died in Kilifi District Hospital (KDH) and, where available, laboratory confirmed SCD status for those who died in the community. Results Overall, 6% and 5% of deaths were attributed to SCD on the basis of PCVA and the InterVA-4 model, respectively. Of the total deaths, 22% occurred in hospital, where the agreement coefficient (AC1) for SCD between PCVA and hospital physician diagnosis was 95.5%, and agreement between InterVA-4 and hospital physician diagnosis was 96.9%. Confirmatory laboratory evidence of SCD status was available for 15% of deaths, in which the AC1 against PCVA was 87.5%. Conclusions Other recent studies and provisional data from this study, outlining the importance of SCD as a cause of death in children in many parts of the developing world, contributed to the inclusion of specific SCD

  9. Die kalte Zunge

    NASA Astrophysics Data System (ADS)

    Bartels, Sören; Müller, Rüdiger

    Gefühlte Temperaturen. Ist ein Null Grad Celsius kalter Metallstab eigentlich kälter als ein Holzstab mit der selben Temperatur? Rein physikalisch gesehen natürlich nicht, aber wenn wir beide Stäbe anfassen, kommt uns der Metallstab deutlich kälter vor. Und wer kennt nicht die Szene aus dem Film Dumm und Dümmer in der Harry mit seiner Zunge am Metallrahmen des Skilifts hängen bleibt.Würde das auch passieren, wenn man an einem eiskalten Stück Holz lecken würde? Wohl kaum, doch woran liegt das eigentlich? Unterschiedliche Materialien haben verschiedene Fähigkeiten, Wärme zu übertragen und zu leiten. So transportiert Metall die von der Zunge ausgehende Wärme sehr schnell weiter und verändert seine Temperatur kaum, während die Zunge abkühlt. Holz hingegen leitet Wärme fast gar nicht und daher wird der Teil, der von der Zunge berührt wird, aufgewärmt.

  10. Receipt of Life-Sustaining Treatments for Taiwanese Pediatric Patients Who Died of Cancer in 2001 to 2010: A Retrospective Cohort Study.

    PubMed

    Hung, Yen-Ni; Liu, Tsang-Wu; Lin, Dong-Tsamn; Chen, Yueh-Chih; Chen, Jen-Shi; Tang, Siew Tzuh

    2016-04-01

    Aggressive life-sustaining treatments have the potential to be continued beyond benefit, but have seldom been systematically/nationally explored in pediatric cancer patients. Furthermore, factors predisposing children dying of cancer to receive life-sustaining treatments at end of life (EOL) have never been investigated in a population-based study. This population-based study explored determinants of receiving life-sustaining treatments in pediatric cancer patients' last month of life. For this retrospective cohort study, we used administrative data on 1603 Taiwanese pediatric cancer patients who died in 2001 to 2010. Individual patient-level data were linked with encrypted identification numbers from the National Register of Deaths Database, Cancer Registration System database, National Health Insurance claims datasets, and Database of Medical Care Institutions Status. Life-sustaining treatments included intensive care unit (ICU) care, cardiopulmonary resuscitation (CPR), and mechanical ventilation. Associations of patient, physician, hospital, and regional factors with receiving ICU care, CPR, and mechanical ventilation in the last month of life were evaluated by multilevel generalized linear mixed models. In their last month of life, 22.89%, 46.48%, and 61.45% of pediatric cancer patients received CPR, mechanical ventilation, and ICU care, respectively, with no significant decreasing trends from 2001 to 2010. Patients were more likely to receive all three identified life-sustaining treatments at EOL if they were diagnosed with a hematologic malignancy or a localized disease, died within 1 year of diagnosis, and received care from a pediatrician. Receipt of ICU care or mechanical ventilation increased with increasing EOL-care intensity of patients' primary hospital, whereas use of mechanical ventilation decreased with increasing quartile of hospice beds in the patients' primary hospital region. Taiwanese pediatric cancer patients received aggressive life

  11. Supporting dignified dying in the Philippines

    PubMed Central

    Doorenbos, Ardith Z; Abaquin, Carmencita; Perrin, Margot E; Eaton, Linda; Balabagno, Araceli O; Rue, Tessa; Ramos, Rita

    2011-01-01

    Purpose This study aimed to assess the appropriateness of the International Classification for Nursing Practice (ICNP) Palliative Care for Dignified Dying catalogue for palliative nursing in the Philippines. Methods The study recruited 230 nurses to complete the ICNP Dignified Dying survey. Participants rated ICNP nursing intervention items and identified additional interventions for promoting dignified dying. Results All of the intervention items were scored on average as being at least ‘slightly important’. The three top-ranked nursing intervention categories were providing social support, maintaining privacy boundaries, and relieving psychological distress. Conclusions The ICNP Palliative Care for Dignified Dying catalogue lists nursing interventions that are appropriate to promoting dignity at the end of life in the Philippines. PMID:21471908

  12. Heated die facilitates tungsten forming

    NASA Technical Reports Server (NTRS)

    Chattin, J. H.; Haystrick, J. E.; Laughlin, J. C.; Leidy, R. A.

    1966-01-01

    Tungsten forming in a press brake employs a bottom die assembly with a heating manifold between two water-cooled die sections. The manifold has hydrogen-oxygen burners spaced along its length for even heat during forming.

  13. 'We Have No Dying Patients'

    ERIC Educational Resources Information Center

    Robinson, Lisa

    1974-01-01

    A course on death and dying offered by the University of Maryland School of Nursing focuses on developing relationships between health care workers and dying people, using actual clients as the vehicle for learning. (Author/EA)

  14. Designing a Die for Hydroforming

    NASA Astrophysics Data System (ADS)

    Vasile, Radu

    2016-12-01

    Designing a die is in every application field an intensive process of bringing together know how from design, testing and every-day use from previous dies with the new application requirements. Contribution deals with a knowledge oriented, modular and feature integrated computer aided design system for die development. This paper describes the concepts behind designing a hydroforming die for sheet metal forming, with easy application-use in small workshops for testing hydroforming capabilities of different materials.

  15. Laboratory and Performance Studies of Anti-wear Coatings Deposited on Nitrided Surfaces of Tools used in an Industrial Hot Die Forging Process

    NASA Astrophysics Data System (ADS)

    Hawryluk, Marek; Widomski, Paweł; Smolik, Jerzy; Kaszuba, Marcin; Ziemba, Jacek; Gronostajski, Zbigniew

    2017-04-01

    The paper presents the results of laboratory studies performed on produced anti-wear coatings as well as the results of performance tests conducted on tools with these coatings in industrial conditions, in the process of hot die forging. Three different coatings were selected: AlCrTiSiN, Cr/CrN and AlCrTiN, deposited by means of the vacuum-arc method on test samples as well as forging tools used in the hot forging process of a lid. The first part of the paper discusses the results of the studies performed in laboratory conditions, which included: surface morphology by means of SEM, hardness and Young modulus measurements, determination of the chemical composition by means of the EDS method, adhesion tests by means of the scratch method and tribological tests by means of the ball-on-disk method. The obtained results were correlated and applied in the analysis of the performance tests on forging punches with these coatings at an early stage of their performance (up to 4000 produced forgings), which were tested on 19 tools, of which 3 representatives were selected for each coating. A thorough analysis was performed of the wear phenomena and mechanisms and the manner of wear of hybrid layers as well as their resistance to the particular destructive mechanisms. Based on the performed laboratory and performance studies as well as their analysis, it was possible to select the optimal hybrid layer, which enables an increase in the durability of forging tools used in industrial hot die forging processes. The preliminary results showed that the best results for the whole working surface of the tool were obtained for the Cr/CrN layer, which characterizes in high adhesion as well as a lower Young modulus and hardness. In the case of high pressures and the correlated friction, better results were obtained for the AlCrTiN coating, which, besides its good adhesion properties, also exhibited the highest frictional resistance.

  16. 'Less ticking the boxes, more providing support': A qualitative study on health professionals' concerns towards the Liverpool Care of the Dying Pathway.

    PubMed

    Di Leo, Silvia; Romoli, Vittoria; Higginson, Irene J; Bulli, Francesco; Fantini, Susanna; Sguazzotti, Erica; Costantini, Massimo

    2015-06-01

    Despite being widely used, research into the effectiveness of the Liverpool Care of the Dying Pathway (LCP) and associated cases of malpractice does not match dissemination. No study exists focusing on concerns voiced by professionals. To explore the views of professionals who, during the hospital implementation of the Italian version of the Liverpool Care of the Dying Pathway (LCP-I), voiced or showed concerns towards it. A qualitative study nested within the LCP-I randomized cluster trial, with semi-structured interviews analysed using thematic analysis. Six nurses and five physicians from six out of the eight hospital wards who completed the LCP-I implementation were interviewed. Eligibility criteria were having taken part in all steps of the LCP-I Programme, voiced or somehow shown concerns, or failed to fully engage with the implementation process. A total of 12 categories were identified, referring to four topics: the Implementation Programme, the LCP-I clinical documentation, the hospital environment and the educational and professional background of hospital healthcare staff. Issues raised by participants concerned both 'real' characteristics of the LCP-I and a misinterpretation of the LCP-I approach and clinical documentation. Furthermore, difficulties were reported which were not linked to the Programme but rather to end-of-life care. This study provides insights into the experience of professionals with negative opinions of or concerns with the LCP-I. A more comprehensive approach to professional training in palliative care is needed and may envisage the development of new interventions aimed at improving the quality of care throughout the illness trajectory. © The Author(s) 2015.

  17. 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…

  18. Relatives' perspective on the terminally ill patients who died after euthanasia or physician-assisted suicide: a retrospective cross-sectional interview study in the Netherlands.

    PubMed

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

    2007-01-01

    This study used retrospective interviews with 87 relatives to describe the experiences of patients who died by euthanasia or physician-assisted suicide (EAS) in the Netherlands. Most of the patients suffered from cancer (85%). The relatives were most often a partner (63%) or a child (28%) of the patient. Before explicitly requesting EAS most patients (79%) had spoken about their wishes concerning medical end-of-life decisions to be made at a later date. Hopeless suffering, loss of dignity, and no prospect of recovery were the most prevalent reasons for explicitly requesting EAS. According to the relative, in 92% of patients EAS had contributed favourably to the quality of the end of life, mainly by preventing or ending suffering.

  19. Specified critical period of different congenital abnormalities: a new approach for human teratological studies.

    PubMed

    Czeizel, Andrew E

    2008-09-01

    The first trimester has been evaluated at different exposures as the critical period of congenital abnormalities. However, the first trimester concept has no scientific basis because environmental agents (teratogens) cannot induce congenital abnormalities during the first gestational month calculated from the first day of the last menstrual period. In addition, the critical period of some congenital abnormalities, for example, hypospadias occurs after the first trimester). Different congenital abnormalities have different critical periods and computer-based evaluation programs help to evaluate different specified congenital abnormalities according to their specific critical periods separately. Thus, this new and feasible approach is recommended for epidemiological and clinical studies in the future after an international consensus in the specified critical periods of different congenital abnormalities. The author of this Commentary proposes a detailed database for this approach for discussion because a consensus may be achieved only after the confirmation or modification of these critical periods.

  20. Utilization of critical periods during development to study the effects of low levels of environmental agents

    SciTech Connect

    Russell, L. B.

    1980-01-01

    Careful definition of critical periods in the development of selected characters can result in experimental systems that may be highly useful in studying risk at low levels of exposure. Three examples are presented. Epidemiological investigations can lose much of their value unless critical periods are known for the end points being studied.

  1. Reflections on Teaching Periodic Table Concepts: A Case Study of Selected Schools in South Africa

    ERIC Educational Resources Information Center

    Mokiwa, Hamza Omari

    2017-01-01

    The Periodic Table of Elements is central to the study of modern Physics and Chemistry. It is however, considered by teachers as difficult to teach. This paper reports on a case study exploring reflections on teaching periodic table concepts in five secondary schools from South Africa. Qualitative methodology of interviews and document analysis…

  2. Dying with dignity.

    PubMed

    Madan, T N

    1992-08-01

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

  3. Rep. George Brown dies

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    George E. Brown, ranking Democratic member of the U.S. House of Representatives Science Committee, died on July 15 at the age of 79 due to complications following a heart valve replacement last May. He was a strong advocate for science and environmental protection measures, and an independent thinker who sometimes found himself alone or far ahead of other people on issues. A congressman for 34 years who represented first the 29th Congressional District and then the 42nd District in California, Brown served on the science committee since 1965 and was chair from 1991 through 1994.

  4. A use study of speech pathology and audiology periodicals at Illinois State University.

    PubMed Central

    Duran, N; Buckley, C E; Ng, M L

    1997-01-01

    No core list of periodicals exists for speech pathology and audiology. Faced with the prospect of having to cancer periodicals for all subjects, the science librarians at Illinois State University decided to determine which science periodicals were used most heavily. A one-year study of science periodical reshelving and interlibrary loan requests yielded ranked lists of periodicals important to speech pathology and audiology faculty and students at Illinois State University. The three most heavily used journals were the Journal of Speech and Hearing Research, ASHA, and Topics in Language Disorders. Most of the periodicals on the lists were indexed by either MEDLINE or UnCover, or by both. While the lists of journals developed in the study are not sufficient to serve as true core lists, they should be useful to libraries supporting comparable programs in speech pathology and audiology. PMID:9431426

  5. A use study of speech pathology and audiology periodicals at Illinois State University.

    PubMed

    Duran, N; Buckley, C E; Ng, M L

    1997-10-01

    No core list of periodicals exists for speech pathology and audiology. Faced with the prospect of having to cancer periodicals for all subjects, the science librarians at Illinois State University decided to determine which science periodicals were used most heavily. A one-year study of science periodical reshelving and interlibrary loan requests yielded ranked lists of periodicals important to speech pathology and audiology faculty and students at Illinois State University. The three most heavily used journals were the Journal of Speech and Hearing Research, ASHA, and Topics in Language Disorders. Most of the periodicals on the lists were indexed by either MEDLINE or UnCover, or by both. While the lists of journals developed in the study are not sufficient to serve as true core lists, they should be useful to libraries supporting comparable programs in speech pathology and audiology.

  6. Accurate Die Design for Automotive Panel Stamping Considering the Compensation Related with Die Deflection and Blank Thinning

    NASA Astrophysics Data System (ADS)

    Chen, Jun; Xu, Dongkai; Xia, Guodong; Li, Xifeng; Chen, Jieshi; Zhang, Jian; Yan, Wei; Li, Yue

    2011-08-01

    In order to improve assembly accuracy, automotive body panels have to be fabricated with higher dimensional and surface quality requirements, therefore the die faces should be designed more accurately to consider more relevant factors. In the presented study, we proposed algorithms to realize the following functions: through forming process simulation, the thinning distribution on the deformed blank was extracted as first kind of compensation; through die structural CAE analysis which automatically mapped the boundary contact forces onto the die surfaces from process simulation results, the die deflection was calculated as second kind of compensation. These two quantitative contributions were added together to compensate the die face. The proposed methodologies were programmed and integrated with LS-Dyna and HyperWorks, and also integrated with Autoform and CATIA linear CAE functionalities separately. In addition, a software toolkit to calculate the contacting ratio was also developed to evaluate the effectiveness of die face compensation. The second toolkit developed was verified by an automotive structural part forming die design, through die compensation and geometric optimization, the predicted contact ratio between the die face and formed blank was improved a lot, and the first toolkit was testified by a fender drawing die design. It shows that the die face compensation can be realized and integrated seamlessly between CAD model, process simulation model and die structural CAE model with the help of data I/O tools developed by the authors.

  7. Periodic variation in the geomagnetic activity - A study based on the Ap index

    NASA Technical Reports Server (NTRS)

    De Gonzalez, Alicia L. C.; Gonzalez, Walter D.; Dutra, Severino L. G.; Tsurutani, Bruce T.

    1993-01-01

    The monthly and daily samples of the Ap index for the interval from 1932 through 1982 were studied using the power spectrum technique. Results obtained for Bartel's period (about 27 days), the semiannual period, the dual-peak solar cycle distribution of geomagnetic storms, and certain other medium-scale periodicities are examined in detail. In addition, results on the cumulative occurrence number of storms per decade as a function of the Ap and Dst indices for the storm are presented.

  8. A Study of the Orbital Periods of Deeply Eclipsing SW Sextantis Stars

    NASA Astrophysics Data System (ADS)

    Boyd, D.

    2012-06-01

    Results are presented of a five-year project to study the orbital periods of eighteen deeply eclipsing novalike cataclysmic variables, collectively known as SW Sextantis stars, by combining new measurements of eclipse times with published measurements stretching back in some cases over fifty years. While the behavior of many of these binary systems is consistent with a constant orbital period, it is evident that in several cases this is not true. Although the time span of these observations is relatively short, evidence is emerging that the orbital periods of some of these stars show cyclical variation with periods in the range 10-40 years. The two stars with the longest orbital periods, V363 Aur and BT Mon, also show secular period reduction with rates of -6.6 x 10-8 days/year and -3.3 x 10-8 days/year. New ephemerides are provided for all eighteen stars to facilitate observation of future eclipses.

  9. 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.

  10. Die großen Zeppeline: Die Geschichte des Luftschiffbaus

    NASA Astrophysics Data System (ADS)

    Kleinheins, Peter; Meighörner, Wolfgang

    Über die glanzvolle Zeit der Zeppeline sind viele Bücher erschienen, die vorwiegend den Einsatz der Luftschiffe in Frieden und Krieg schildern. Nur wenige wissen, dass die Baugeschichte der Zeppeline eine der faszinierendsten Phasen der modernen Technik ist. Peter Kleinheins hat dieses Geschehen sachkundig aufgearbeitet und zusammengestellt. Entstanden ist eine reich illustrierte Dokumentation in einer interessanten Mischform aus zeitgenössischen Berichten und hochwertigen Originalquellen.

  11. The impact of a palliative care educational component on attitudes toward care of the dying in undergraduate nursing students.

    PubMed

    Mallory, Judy L

    2003-01-01

    Nurse educators have identified that historically nurses have not been prepared to care for dying patients. Research also has identified that nursing students have anxieties about death, dying, and caring for dying patients. Several factors have been identified as affecting nurses' and nursing students' attitudes toward care of the dying. Factors addressed in this research were current and previous death education. This research incorporated experiential learning using a model of death education and transformative learning theory. The educational experiences were geared to help students understand the skills needed to care competently and compassionately for the dying. The use of the End of Life Nursing Education Consortium (ELNEC) education package along with experiences at the hospice, the funeral home, the anatomy laboratory, and role play helped facilitate transformative learning in the nursing students. The study examined the effects of an educational experience to determine if a one-time educational experience provides sufficient, lasting effects in a 6-week format. Results of this study indicate that education can have a positive effect on nursing students' attitudes toward care of the dying. Nursing students in the intervention group had a significant positive increase in their attitudes toward care of the dying after the intervention. The attitude change increased slightly after a 4-week period.

  12. ["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.

  13. Old habits die hard: a case study on how new ways of teaching colonoscopy affect the habitus of experienced clinicians.

    PubMed

    Lund, Ole; Andersen, Berit; Christensen, Mette K

    2016-09-19

    The purpose of this study is to explore the habitual constraints and opportunities that affect how experienced clinicians learn new skills and, in particular, how new ways of teaching can influence these.   We conducted a case study based on a specialized training program for colonoscopy services in Denmark. Data was obtained from a short-term ethnographic fieldwork and in-depth interviews during this program. Participants were 12 experienced colonoscopists and three expert colonoscopy trainers from Denmark and UK. The analysis of data involved categorization, inductive coding, and theoretical reading inspired by sociological theory. The experienced clinicians' responsiveness to training was shaped by an underlying logic of colonoscopy practice that was characterized by tacit skills, routine work, lower status, skepticism and self-protectiveness. In order to overcome these habitual constraints, the trainers applied a pedagogical approach based on four methods: 1) intellectualization: 'academization' of skills and competencies, 2) sensing and scaffolding: hands-on experiences and learning by doing, 3) asymmetry: accentuating the authority and respect of the trainer, and 4) relation-building: building relationship and engagement between trainer and clinician. This multi-dimensional approach to teaching enabled the trainers to affect the clinicians' logic of practice and to create buy-in (so-called illusio). Clinical skills include socially constructed behaviors and unconscious competences which affect experienced clinicians' responsiveness to continuing medical education. This study suggests four educational strategies that may help trainers to establish new logics of practice in experienced clinicians and to improve the clinicians' conscious competence.

  14. 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.

  15. Ethical challenges when caring for dying children.

    PubMed

    Furingsten, Lovisa; Sjögren, Reet; Forsner, Maria

    2015-03-01

    Caring for dying children presents special challenges, according to the children themselves, their relatives and healthcare professionals. The aim of this study was to describe caring as represented in healthcare workers' experiences of caring for dying children. A phenomenological approach was chosen, in-depth interviews were carried out and data were analysed in four steps focusing on (a) open reading, (b) meaning units, (c) constituents and (d) essence. Four nurses in a general acute paediatric care setting in Sweden participated after providing written informed consent. Voluntary participation and confidentiality were ensured, and the study was ethically approved. The essence of caring for dying children was likened to a musically attuned composition, comprising five constituents: presence, self-knowledge, injustice in dying, own suffering and in need of others. Presence was found to be a prerequisite for caring when a child is dying. Self-knowledge and support from others can be of help when struggling with emotional pain and injustice. Caring for dying children has been found to be a delicate task for healthcare workers all over the world, and the ethical dimension is emphasized in international research. In this study, emotional pain and suffering accompanied caring, but an atmosphere in which it is possible to give and get support from colleagues and to have time to grieve and time to focus on the patient's needs may ease the burden, as can having time to process thoughts about life and death, and a possibility to grow in self-knowledge. Caring in ethically demanding situations may be facilitated through presence, atmosphere, self-knowledge and time. The challenge does not demand highly technological solutions; these assets are readily available, no matter where on earth. However, there is a need to further investigate these prerequisites for caring, particularly when a child is dying. © The Author(s) 2014.

  16. Old habits die hard: a case study on how new ways of teaching colonoscopy affect the habitus of experienced clinicians

    PubMed Central

    Lund, Ole; Andersen, Berit

    2016-01-01

    Objectives The purpose of this study is to explore the habitual constraints and opportunities that affect how experienced clinicians learn new skills and, in particular, how new ways of teaching can influence these. Methods We conducted a case study based on a specialized training program for colonoscopy services in Denmark. Data was obtained from a short-term ethnographic fieldwork and in-depth interviews during this program. Participants were 12 experienced colonoscopists and three expert colonoscopy trainers from Denmark and UK. The analysis of data involved categorization, inductive coding, and theoretical reading inspired by sociological theory. Results The experienced clinicians' responsiveness to training was shaped by an underlying logic of colonoscopy practice that was characterized by tacit skills, routine work, lower status, skepticism and self-protectiveness. In order to overcome these habitual constraints, the trainers applied a pedagogical approach based on four methods: 1) intellectualization: 'academization' of skills and competencies, 2) sensing and scaffolding: hands-on experiences and learning by doing, 3) asymmetry: accentuating the authority and respect of the trainer, and 4) relation-building: building relationship and engagement between trainer and clinician. This multi-dimensional approach to teaching enabled the trainers to affect the clinicians' logic of practice and to create buy-in (so-called illusio). Conclusions Clinical skills include socially constructed behaviors and unconscious competences which affect experienced clinicians' responsiveness to continuing medical education. This study suggests four educational strategies that may help trainers to establish new logics of practice in experienced clinicians and to improve the clinicians' conscious competence. PMID:27643986

  17. A Study to Determine the Optimal Frequency for Conducting Periodic Dental Examinations, Recruit Needs. Part II.

    DTIC Science & Technology

    1980-06-01

    HEALTH CARE STUDIES DIVISION REPORT #80-004 A STUDY TO DETERMINE THE OPTIMAL FREQUENCY FOR CONDUCTING PERIODIC DENTAL EXAMINATIONS RECRUIT NEEDS (Part...CONDUCTING PERIODIC DENTAL EXAMINATIONS - RECRUIT July 1979 to June 1980 NEEDS PART II G. PERFORMING ORG. REPORT NUMBER 7. AUTHOR(*) 8. CONTRACT OR GRANT...KEY WORDS (Continue an reveree side if neceeary end Identify by block number) Dental ; Recruits; Care needs; Treatment Time; Age; Oral health 2a *srhA&T

  18. Graphite/Thermoplastic-Pultrusion Die

    NASA Technical Reports Server (NTRS)

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

    1990-01-01

    Attachment to extruder produces thermoplastic-impregnated graphite tape. Consists of profile die, fiber/resin collimator, and crosshead die body. Die designed to be attached to commercially available extrusion machine capable of extruding high-performance thermoplastics. Simple attachment to commercial extruder enables developers of composites to begin experimenting with large numbers of proprietary resins, fibers, and hybrid composite structures. With device, almost any possible fiber/resin combination fabricated.

  19. Die Milchstraße.

    NASA Astrophysics Data System (ADS)

    Henbest, N.; Couper, H.

    This book is a German translation, by M. Röser, from the English original "The guide to the Galaxy", published in 1994 (see Abstr. 61.003.065). Contents: 1. Die Entdeckung unserer Galaxis. 2. Die Lokale Gruppe. 3. Die Geographie der Galaxis. 4. Der Perseus-Arm. 5. Der Orion-Arm. 6. Unsere lokale Nachbarschaft: ein typischer Winkel der Galaxis. 7. Der Sagittarius-Arm: innerhalb der Sonnenumlaufbahn. 8. Das Zentrum der Galaxis.

  20. Graphite/Thermoplastic-Pultrusion Die

    NASA Technical Reports Server (NTRS)

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

    1990-01-01

    Attachment to extruder produces thermoplastic-impregnated graphite tape. Consists of profile die, fiber/resin collimator, and crosshead die body. Die designed to be attached to commercially available extrusion machine capable of extruding high-performance thermoplastics. Simple attachment to commercial extruder enables developers of composites to begin experimenting with large numbers of proprietary resins, fibers, and hybrid composite structures. With device, almost any possible fiber/resin combination fabricated.

  1. Effect of Die Strength and Work Piece Strength on the Wear of Hot Forging Dies

    NASA Astrophysics Data System (ADS)

    Levy, B. S.; Van Tyne, C. J.

    2015-01-01

    The effect of the strength ratio extracted from an Archard model for wear is used to describe the wear rates expected in hot forging dies. In the current study, the strength ratio is the strength of the hot forging die to the strength of the work piece. Three hot forging die steels are evaluated. The three die steels are FX, 2714, and WF. To determine the strength of the forging die, a continuous function has been developed that describes the yield strength of three die steels for temperatures from 600 to 700 °C and for times up to 20 h (i.e., tempering times of up to 20 h). The work piece material is assumed to be AISI 1045. Based on the analysis, the wear resistance of WF should be superior and FX should be slightly better than 2714. Decreasing the forging temperature increases the strength ratio, because the strength of the die surface increases faster than the flow strength of AISI 1045. The increase in the strength ratio indicates a decrease in the expected wear rate.

  2. Deformation properties of pharmaceutical excipients determined using an in-die and out-die method.

    PubMed

    Ilić, Ilija; Govedarica, Biljana; Šibanc, Rok; Dreu, Rok; Srčič, Stane

    2013-03-25

    This study investigated deformation mechanisms of some commonly used pharmaceutical fillers, such as microcrystalline cellulose, lactose, dicalcium phosphate, isomalt and cornstarch, using a combination of the in-die and out-die method with the Heckel and Walker models. The tableting mixtures contained of 98.5% (w/w) filler, the rest consisted of dry binder and an antiadhesive agent. Our results showed that plasticity and elasticity may be considered independent deformation properties as highly plastic materials (microcrystalline cellulose, cornstarch) also exhibited high elasticity. Particular emphasis was placed on explaining the differences observed between the in-die and out-die method-comparison revealed that the differences are a consequence of the material's elastic properties. Larger error of in-die results can be expected for more elastic materials, and thus in-die Heckel should be used with some considerations. In contrast, the Walker model was found to be more robust and smaller differences were observed between the two methods. We consider the most correct results to have been obtained by the out-die approach, which excludes the elastic properties of the material evaluated. An excellent correlation between elastic determination at the single-particle level and multiple-particle scale was demonstrated, suggesting a great potential of nanoscale determination of a material's mechanical properties for better elucidation of deformation mechanisms. Copyright © 2013 Elsevier B.V. All rights reserved.

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

    SciTech Connect

    Hamm, Randy; Peterson, Kenneth A.

    2015-10-01

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

  4. Volar locking plate (VLP) versus non-locking plate (NLP) in the treatment of die-punch fractures of the distal radius, an observational study.

    PubMed

    Zhang, Xiong; Hu, Chunhe; Yu, Kunlun; Bai, Jiangbo; Tian, Dehu; Xu, Yi; Zhang, Bing

    2016-10-01

    This study aims to evaluate whether volar locking plate was superior over non-locking plate in the treatment of die-punch fractures of the distal radius. A total of 57 patients with closed die-punch fractures of the distal radius were included and analyzed. Of them, 32 were treated by non-locking plate (NLP) and the remaining 25 were treated by volar locking plate (VLP). Preoperative radiographs, computer tomographs and three-dimensional reconstruction, radiographs taken at immediate postoperation and at last follow-up were extracted and evaluated. Patients' electronic medical records were inquired and related demographic and medical data were documented. The documented contents were volar tilt, radial inclination, ulnar variance, grip strength, Disabilities of the Arm, Shoulder, and Hand (DASH) and visual analog scale (VAS) scores and complications. VLP group demonstrated a significantly reduced radial subsidence of 1.5 mm (0.7 versus 2.2 mm), during the interval of bony union (P < 0.001), compared to NLP group. Larger proportion of patients (88% versus 62.5%) in VLP group gained acceptable joint congruity (step-off <2 mm) at the final follow-up (P = 0.037). No significant differences were observed between the groups in the measurements of volar tilt, radial inclination, DASH, VAS and grip strength recovery at the last follow-up. There was a trend of fewer overall complications (5/25 versus 10/32) and major complications that required surgery interventions (1/25 versus 4/32) in VLP than NLP groups, although the difference did not approach to significance (P = 0.339, 0.372). VLP leaded to significantly better results of reduction maintainance and the final joint congruity than NLP, while reducing overall and major complications. However, the results should be treated in the context of limitations and the clinical significance of the difference required further studies to investigate. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd

  5. Are Seminar Periods Supportive of the Professional Development of Social Studies Teachers?

    ERIC Educational Resources Information Center

    Demir, Selçuk Besir; Dogan, Soner; Atasoy, Turgay

    2016-01-01

    The purpose of this study is to determine the efficiency of the seminar periods intended for contributing to the professional development of social studies teachers based on their own perspectives. This study adopts a qualitative approach and is carried out in the form of a case study. Among the purposeful sampling methods, the criteria sample…

  6. Further studies of the pulsation period and orbital elements of Centaurus X-3

    NASA Technical Reports Server (NTRS)

    Fabbiano, G.; Schreier, E. J.

    1977-01-01

    The long- and short-term variability of the 4.8-s pulsation and the 2.1-day orbital periods of Centaurus X-3 are studied. The pulsation period decreases over 4 yr with a fractional change of -0.00028 per yr, but with rms fluctuations of 0.0002 s. In August-September 1972, a continuous transition from speedup to slowdown was observed. The orbital period also decreases over 4 yr with decrease of approximately 8 millionths per yr, and with significant fluctuations of the order of 0.00001 day over months. The orbital eccentricity is found to be about 0.0008. The pulsation-period variability is found to be consistent with a near balance between the Alfven and corotation radii in an accretion-disk model. The orbital-period variability is interpreted in terms of tidal circularization and possible mass transfer and loss.

  7. Retrospective cohort study of all deaths among infants born between 22 and 27 completed weeks of gestation in Switzerland over a 3-year period.

    PubMed

    Berger, T M; Steurer, M A; Bucher, H U; Fauchère, J C; Adams, M; Pfister, R E; Baumann-Hölzle, R; Bassler, D

    2017-06-15

    The aim of this research is to assess causes and circumstances of deaths in extremely low gestational age neonates (ELGANs) born in Switzerland over a 3-year period. Population-based, retrospective cohort study. All nine level III perinatal centres (neonatal intensive care units (NICUs) and affiliated obstetrical services) in Switzerland. ELGANs with a gestational age (GA) <28 weeks who died between 1 July 2012 and 30 June 2015. A total of 594 deaths were recorded with 280 (47%) stillbirths and 314 (53%) deaths after live birth. Of the latter, 185 (59%) occurred in the delivery room and 129 (41%) following admission to an NICU. Most liveborn infants dying in the delivery room had a GA ≤24 weeks and died following primary non-intervention. In contrast, NICU deaths occurred following unrestricted life support regardless of GA. End-of-life decision-making and redirection of care were based on medical futility and anticipated poor quality of life in 69% and 28% of patients, respectively. Most infants were extubated before death (87%). In Switzerland, most deaths among infants born at less than 24 weeks of gestation occurred in the delivery room. In contrast, most deaths of ELGANs with a GA ≥24 weeks were observed following unrestricted provisional intensive care, end-of-life decision-making and redirection of care in the NICU regardless of the degree of immaturity. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Emotional anticipation after delivery - a longitudinal neuroimaging study of the postpartum period.

    PubMed

    Gingnell, Malin; Toffoletto, Simone; Wikström, Johan; Engman, Jonas; Bannbers, Elin; Comasco, Erika; Sundström-Poromaa, Inger

    2017-03-08

    Neuroimaging research has begun to unveil the mechanisms behind emotion processing during the postpartum period, which, in turn, may be of relevance for the development of postpartum depression. The present study sought to longitudinally investigate the neural correlates of emotion anticipation during the postpartum period in healthy women. Functional magnetic resonance imaging was employed to measure the blood oxygen level-dependent signal in the brain in response to anticipation of negative emotional stimuli and during processing of images with positive or negative valence. The participating women were scanned twice: the first scan occurred during the first 48 hours after delivery, and the second was performed 4-6 weeks after delivery. The early postpartum period was characterized by higher anterior cingulate cortex reactivity during anticipation of negative emotional stimuli than the late postpartum period. This was accompanied by a negative relationship with insular reactivity during the early postpartum period and a trend towards an increase in insular reactivity in the late postpartum period. Thus, during the first four weeks of the postpartum period, a diminished top-down regulatory feedback on emotion-related areas of the brain was noted. This finding suggests a physiologically important adaptation during the healthy postpartum period.

  9. An Observational Study to Explore the Feasibility of Assessing Bereaved Relatives' Experiences Before and After a Quality Improvement Project to Improve Care of Dying Medical Inpatients.

    PubMed

    Clark, Katherine; Willis, Abby; Byfieldt, Naomi

    2017-04-01

    Although hospitals are the most likely place of death, the quality of care received by dying inpatients remains variable. This is concerning for both the dying person and their relatives, with poorer bereavement outcomes likely for those who perceived their family member suffered unduly. There is a real need to consider how this situation can be improved. This work was conducted with the aim of exploring the feasibility of including bereaved relatives' experiences as part of a larger project exploring the use of a care bundle to improve care of the dying inpatients. Fifty relatives of inpatients who had died previously in hospital were contacted by letter with a request for interview before the implementation of a care bundle for the dying, with a care bundle being a collection of care processes that are implemented together. After this project had been in place for 6 months, a further 50 families were contacted who had died on the bundle. Ten families responded initially to the first request and 10 the second, with the interviews based on the Quality of Dying and Death (QODD) tool and a final open-ended question. Although all families who agree to be interviewed completed the session, with regard to the QODD, some families indicated that they would rather talk than provide numeric scores. No major differences in the prescores and postscores were noted. When invited to share their experiences, without prompting, families spoke of consistent concerns that included communication, place of death, and symptom control. This work confirms that it is highly feasible to incorporate assessments of bereaved family members' opinions as part of the wider assessment of research into end-of-life care.

  10. On the emotional connection of medical specialists dealing with death and dying: a qualitative study of oncologists, surgeons, intensive care specialists and palliative medicine specialists.

    PubMed

    Zambrano, Sofia Carolina; Chur-Hansen, Anna; Crawford, Gregory B

    2012-09-01

    This paper reports on qualitative data exploring the experiences and coping mechanisms of medical specialists from the specialties of intensive care, surgery, oncology and palliative care, when dealing with death and dying and their emotional connection with dying patients in the context of a life-threatening illness. Thirty-three semi-structured individual interviews were analysed using thematic analysis. One of the key themes of medical specialists' experiences with death and dying was their ambivalence about developing emotional connections with patients and families. Advantages of not engaging emotionally with patients were related to preserving objectivity in the decision making process, while a perceived disadvantage was the loss of the opportunity to engage in meaningful relationships that could positively influence patients, families and the medical specialist. Finding a balance in the face of ambivalence was a preferred approach and participants employed a variety of coping strategies. Participants took different positions about the emotional connection that should develop with their dying patients and their families. Although there was agreement about finding a balance between objectivity and connection, their strategies for achieving this seem to be subjective and prescribed by individual notions. By sharing perspectives and learning how other colleagues deal with similar issues, there is an opportunity for medical practitioners to develop a well-rounded approach to dealing with death and dying, which may enhance personal and professional relationships and may ultimately influence future generations of medical practitioners.

  11. Optimal recall period for caregiver-reported illness in risk factor and intervention studies: a multicountry study.

    PubMed

    Arnold, Benjamin F; Galiani, Sebastian; Ram, Pavani K; Hubbard, Alan E; Briceño, Bertha; Gertler, Paul J; Colford, John M

    2013-02-15

    Many community-based studies of acute child illness rely on cases reported by caregivers. In prior investigations, researchers noted a reporting bias when longer illness recall periods were used. The use of recall periods longer than 2-3 days has been discouraged to minimize this reporting bias. In the present study, we sought to determine the optimal recall period for illness measurement when accounting for both bias and variance. Using data from 12,191 children less than 24 months of age collected in 2008-2009 from Himachal Pradesh in India, Madhya Pradesh in India, Indonesia, Peru, and Senegal, we calculated bias, variance, and mean squared error for estimates of the prevalence ratio between groups defined by anemia, stunting, and underweight status to identify optimal recall periods for caregiver-reported diarrhea, cough, and fever. There was little bias in the prevalence ratio when a 7-day recall period was used (<10% in 35 of 45 scenarios), and the mean squared error was usually minimized with recall periods of 6 or more days. Shortening the recall period from 7 days to 2 days required sample-size increases of 52%-92% for diarrhea, 47%-61% for cough, and 102%-206% for fever. In contrast to the current practice of using 2-day recall periods, this work suggests that studies should measure caregiver-reported illness with a 7-day recall period.

  12. I Could Have Died Laughing.

    ERIC Educational Resources Information Center

    Maher, Michael Forrest; Smith, Douglas

    1993-01-01

    Notes that caregivers of the dying would do well to consider the prescriptive power of humor when confronting the challenges of healthy care for the terminally ill. Addresses laughter as the best medicine not only for the dying person but also for family and principal caregivers. Includes examples of therapeutic use of humor with the terminally…

  13. Goethe almost died of urosepsis.

    PubMed

    Gross, A J; Hummel, G

    1999-12-01

    In the year of 1805, Goethe almost died of urosepsis. His urological problems were not diseases arising from full health but a new variation in a life accompanied by illnesses. Some sources date the first colics he experienced to the year 1795 and others say 1805. The most dramatic period in the course of his illness was in February, when he suffered from fever of such an extent that one could speak of urosepsis. Recovery took place slowly and was accompanied by minor relapses. Nothing about this is written down in his work. On the advice of his doctors, Goethe undertook a cure in Lauchstädt in July and August. The report of his consultant, Professor Johann Christian Reil, on his problems in the field of urology remained undiscovered until 1937. Professor Reil recommended treatment with thermae carolinae, aqua calcis, soap soda crystallisata, herbae subastringentes, and uva ursi, among other measures. With increasing age, Goethe's colics disappeared. The passing of a stone has never been described. Whereas Goethe hinted about medical problem other than those reported herein, the urological problems discussed in this article were left unmentioned. Nonetheless, literature that deals with Goethe's diseases is interesting from the aspect of both the history of medicine and the history of culture.

  14. Two Piece Compaction Die Design

    SciTech Connect

    Coffey, Ethan N

    2010-03-01

    Compaction dies used to create europium oxide and tantalum control plates were modeled using ANSYS 11.0. Two-piece designs were considered in order to make the dies easier to assemble than the five-piece dies that were previously used. The two areas of concern were the stresses at the interior corner of the die cavity and the distortion of the cavity wall due to the interference fit between the two pieces and the pressure exerted on the die during the compaction process. A successful die design would have stresses less than the yield stress of the material and a maximum wall distortion on the order of 0.0001 in. Design factors that were investigated include the inner corner radius, the value of the interference fit, the compaction force, the size of the cavity, and the outer radius and geometry of the outer ring. The results show that for the europium oxide die, a 0.01 in. diameter wire can be used to create the cavity, leading to a 0.0055 in. radius corner, if the radial interference fit is 0.003 in. For the tantalum die, the same wire can be used with a radial interference fit of 0.001 in. Also, for the europium oxide die with a 0.003 in. interference fit, it is possible to use a wire with a diameter of 0.006 in. for the wire burning process. Adding a 10% safety factor to the compaction force tends to lead to conservative estimates of the stresses but not for the wall distortion. However, when the 10% safety factor is removed, the wall distortion is not affected enough to discard the design. Finally, regarding the europium oxide die, when the cavity walls are increased by 0.002 in. per side or the outer ring is made to the same geometry as the tantalum die, all the stresses and wall distortions are within the desired range. Thus, the recommendation is to use a 0.006 in. diameter wire and a 0.003 in. interference fit for the europium oxide die and a 0.01 in. diameter wire and a 0.001 in. interference fit for the tantalum die. The dies can also be made to have the

  15. Study of periodic motions of a satellite with a magnetic damper

    NASA Technical Reports Server (NTRS)

    Sadov, Y. A.; Teterin, A. D.

    1979-01-01

    The motion of a satellite with a magnetic damper in the plane of a circular polar orbit is studied. The asymptotics of periodic solutions are constructed for a satellite close to axisymmetric and the radius of convergence is evaluated for the power series obtained. In a broad range of values of parameters, a periodic solution is obtained by numerical integration of equations of motion of the satellite. The asymptotics of a bifurcated curve obtained (the curve on which origin of a pair of periodic solutions occurs) in the space of the parameters agrees well with the results of numerical computation with all physical values of these parameters. A breakdown is made of the space of the initial data of phase variables in the field of effect of different types of periodic motion.

  16. Incubation period and immune function: A comparative field study among coexisting birds

    USGS Publications Warehouse

    Palacios, M.G.; Martin, T.E.

    2006-01-01

    Developmental periods are integral components of life history strategies that can have important fitness consequences and vary enormously among organisms. However, the selection pressures and mechanisms causing variation in length of developmental periods are poorly understood. Particularly puzzling are prolonged developmental periods, because their selective advantage is unclear. Here we tested the hypotheses that immune function is stronger in species that are attacked at a higher rate by parasites and that prolonged embryonic development allows the development of this stronger immune system. Through a comparative field study among 12 coexisting passerine bird species, we show that species with higher blood parasite prevalence mounted stronger cellular immune responses than species with lower prevalence. These results provide support for the hypothesis that species facing greater selection pressure from parasites invest more in immune function. However, species with longer incubation periods mounted weaker cellular immune responses than species with shorter periods. Therefore, cellular immune responses do not support the hypothesis that longer development time enhances immunocompentence. Future studies should assess other components of the immune system and test alternative causes of variation in incubation periods among bird species. ?? Springer-Verlag 2005.

  17. Incubation period and immune function: a comparative field study among coexisting birds.

    PubMed

    Palacios, Maria G; Martin, Thomas E

    2006-01-01

    Developmental periods are integral components of life history strategies that can have important fitness consequences and vary enormously among organisms. However, the selection pressures and mechanisms causing variation in length of developmental periods are poorly understood. Particularly puzzling are prolonged developmental periods, because their selective advantage is unclear. Here we tested the hypotheses that immune function is stronger in species that are attacked at a higher rate by parasites and that prolonged embryonic development allows the development of this stronger immune system. Through a comparative field study among 12 coexisting passerine bird species, we show that species with higher blood parasite prevalence mounted stronger cellular immune responses than species with lower prevalence. These results provide support for the hypothesis that species facing greater selection pressure from parasites invest more in immune function. However, species with longer incubation periods mounted weaker cellular immune responses than species with shorter periods. Therefore, cellular immune responses do not support the hypothesis that longer development time enhances immunocompentence. Future studies should assess other components of the immune system and test alternative causes of variation in incubation periods among bird species.

  18. Utility of ten-second uptake periods for kinetic studies of serotonin uptake by intact platelets

    SciTech Connect

    Costa, J.L.; Kirk, K.L.; Stark, H.

    1981-09-01

    When washed human platelets accumulate serotonin (5HT), it is possible with the use of formaldehyde fixative to measure uptake over periods as short as 10 seconds. To evaluate the utility of these short times for kinetic studies of 5HT uptake, we have examined the accuracy with which the 10 second uptake rate reflects changes in the extracellular 5HT concentration. The amount of 5HT taken up over a 10 second period appears to be determined by the concentration of 5HT present in the extracellular medium during that time period, and the uptake rate can change rapidly following sudden changes in the extracellular 5HT concentration. However, the extent of inhibition of 5HT uptake in the presence of imipramine of extracellular 5HT concentrations greater than 10-5M is somewhat different depending on whether the 5HT is allowed to accumulate for a 10-second or a 5- or 10-minute uptake period. A 10-second uptake period thus appears to be useful for kinetic studies of initial 5HT uptake velocities under normal conditions, but under inhibitory conditions may give results differing from those obtained with minute-long periods.

  19. 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.

  20. Death and dying anxiety among bereaved and nonbereaved elderly parents.

    PubMed

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

    2011-08-01

    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 anxiety scores than nonbereaved parents, but there were no significant differences between the 2 groups in death anxiety. Religiosity was unrelated to death and dying anxiety. Dying anxiety was higher among bereaved mothers than bereaved fathers. Death and dying anxiety were not associated with the length of time since the loss of the child or the nature of the child's death. Results are discussed in light of the difficulties that bereaved parents experience after the loss of their child. Implications for theory, for health and welfare professionals, and for policy are suggested.

  1. Electroencephalography Spectral Power Density in First-Episode Mania: A Comparative Study with Subsequent Remission Period.

    PubMed

    Güven, Sertaç; Kesebir, Sermin; Demirer, R Murat; Bilici, Mustafa

    2015-06-01

    Our aim in this study was to investigate spectral power density (PSD) in first-episode mania and subsequent remission period and to evaluate their difference. Sixty-nine consecutive cases referring to our hospital within the previous 1 year, who were evaluated as bipolar disorder manic episode according to The Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) at the first episode and had the informed consent form signed by first degree relatives, were included in this study. Exclusion criteria included having previous depressive episode, using drugs which could influence electroencephalographic activity before electroencephalography (EEG), and having previous neurological disease, particularly epilepsy, head trauma, and/or loss of consciousness. EEG records were obtained using a digital device in 16 channels; 23 surface electrodes were placed according to the International 10-20 system. Spectral power density (dbμV/Hz) of EEG signal provided information on the power carried out by EEG waves in defined frequancy range per unit frequency in the present study. A peak power value detected on the right with FP2P4 and on the left with F7T3 electrodes were found to be higher in the manic episode than in the remission period (p=0.018 and 0.025). In the remission period, in cases with psychotic symptoms during the manic period, F4C4 peak power value was found to be lower than that in cases with no psychotic findings during the manic period (p=0.027). There was no relation was found between YMRS scores and peak power scores. Electrophysiological corollary of mood episode is present from the onset of the disease, and it differs between the manic and remission periods of bipolar disorder. In the remission period, peak power values of PSD distinguish cases with psychotic findings from cases without psychotic findings when they were manic.

  2. Influence of olive oil on alveolar bone response during orthodontic retention period: rabbit model study.

    PubMed

    Al-Hamdany, Afrah K; Al-Khatib, Ali R; Al-Sadi, Hafidh I

    2017-08-01

    This study attempted to evaluate clinically and histologically the effects of olive oil (Ol) consumption on orthodontic relapse after the retention period. Thirty apparently healthy female albino rabbits, weight more than 1000 g each was used in this study. The animals were grouped randomly into six groups of five animals each: two control and four experimental groups. In control groups, the relapse was estimated either at zero day, or at the end of the fourth week after orthodontic retention period. In the experimental groups, the animals' groups received Ol, 7.7, or 15.4 ml/kg b.w. per day during the orthodontic retention period. The relapse was estimated either at zero day, or at the end of the fourth week after orthodontic retention period for each concentration. Modified fixed orthodontic appliances were attached to the rabbits' lower central incisors. Each rabbit received orthodontic intervention for one week, followed by six weeks retention period. At the end of the experiments, the clinical and histological investigations were conducted. Data analyses were performed at the level of p < .05 for the statistically significant difference. Clinically, Ol high concentration four weeks group showed a significantly lower relapse tendency than control four weeks group. Histologically, Ol low concentration zero time group showed significantly higher osteoblasts numbers than control zero time group. Olive oil low and high concentrations four weeks group showed significantly lower fibroblasts count. Moreover, Ol high concentration four weeks group revealed significantly higher bone mineralization, osteoblasts and osteocytes counts than control four weeks study group. Supplementation with Ol during an orthodontic retention period, especially at 15.4 ml/kg b.w. per day concentration, clinically reduced orthodontic relapse on rabbit model. Histologically, Ol increased osteoblasts and osteocytes counts and the relative amount of bone mineralization of connective

  3. Electroencephalography Spectral Power Density in First-Episode Mania: A Comparative Study with Subsequent Remission Period

    PubMed Central

    GÜVEN, Sertaç; KESEBİR, Sermin; DEMİRER, R. Murat; BİLİCİ, Mustafa

    2015-01-01

    Introduction Our aim in this study was to investigate spectral power density (PSD) in first-episode mania and subsequent remission period and to evaluate their difference. Methods Sixty-nine consecutive cases referring to our hospital within the previous 1 year, who were evaluated as bipolar disorder manic episode according to The Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) at the first episode and had the informed consent form signed by first degree relatives, were included in this study. Exclusion criteria included having previous depressive episode, using drugs which could influence electroencephalographic activity before electroencephalography (EEG), and having previous neurological disease, particularly epilepsy, head trauma, and/or loss of consciousness. EEG records were obtained using a digital device in 16 channels; 23 surface electrodes were placed according to the International 10–20 system. Spectral power density (dbμV/Hz) of EEG signal provided information on the power carried out by EEG waves in defined frequancy range per unit frequency in the present study. Results A peak power value detected on the right with FP2P4 and on the left with F7T3 electrodes were found to be higher in the manic episode than in the remission period (p=0.018 and 0.025). In the remission period, in cases with psychotic symptoms during the manic period, F4C4 peak power value was found to be lower than that in cases with no psychotic findings during the manic period (p=0.027). There was no relation was found between YMRS scores and peak power scores. Conclusion Electrophysiological corollary of mood episode is present from the onset of the disease, and it differs between the manic and remission periods of bipolar disorder. In the remission period, peak power values of PSD distinguish cases with psychotic findings from cases without psychotic findings when they were manic.

  4. Split-field FDTD method for oblique incidence study of periodic dispersive metallic structures.

    PubMed

    Baida, F I; Belkhir, A

    2009-08-15

    The study of periodic structures illuminated by a normally incident plane wave is a simple task that can be numerically simulated by the finite-difference time-domain (FDTD) method. On the contrary, for off-normal incidence, a widely modified algorithm must be developed in order to bypass the frequency dependence appearing in the periodic boundary conditions. After recently implementing this FDTD algorithm for pure dielectric materials, we here extend it to the study of metallic structures where dispersion can be described by analytical models. The accuracy of our code is demonstrated through comparisons with already-published results in the case of 1D and 3D structures.

  5. New Light Curves and Period Studies of V502 OPH W UMA System

    NASA Astrophysics Data System (ADS)

    Awadalla, Nabil S.

    NEW LIGHT CURVES AND PERIOD STUDIES OF V502 OPH W UMa SYSTEM N.S.Awadalla National Research Institute of Astronomy and Geophysics( NRIAG ) Helwan Cairo EGYPT New BVR photoelectric observations of the W UMa eclipsing binary system V502 Oph have been presented and analyzed. The geometric and physical elements of the system have been obtained and compared to the previous results. The classification of the system concerning the sub-type of the W UMa binary has been studied as well as its evolution stage. Its period variation in a view of the light time effect has been examin

  6. Ethics in the publication of studies on human visceral leishmaniasis in Brazilian periodicals.

    PubMed

    Malafaia, Guilherme; Rodrigues, Aline Sueli de Lima; Talvani, André

    2011-02-01

    To analyze ethical aspects of Brazilian articles on human visceral leishmaniasis, published after Resolution CNS 196/1996, and to analyze the policy on Brazilian periodicals on research ethics. An explanatory study with a bibliographical and documental nature was conducted. Selection of publications on research involving human beings since 1996 was performed in the SciELO Brazil database. Gaps associated with editorial policies on medical periodicals, based on information obtained from the "Instructions to authors" section of each periodical, were analyzed. While there were no articles on the compliance with ethical aspects in the first four-year period (from 1997 to 2000), 75% fulfilled at least one of the ethical requirements evaluated in the first year (2009) of a subsequent four-year period (from 2009 to 2012). A total of six out of 11 periodicals indicated that the information about ethical aspects should be mentioned in the body of the article. There were three periodicals that required a letter or document, informing about compliance with these aspects and signed by the author(s), to be sent; two that requested a copy of the document used to obtain the free and informed consent; one that clarified the need of a copy to authorize the approval by the Committee on Ethics in Research; and four in which no requirements of ethical aspects were found. There was an improvement in the description of compliance with ethical aspects found in articles. Standardization of ethical requirements for human research in Brazilian periodicals is suggested. This could promote compliance with the presuppositions of documents regulating human research.

  7. Fear, Pain, Denial, and Spiritual Experiences in Dying Processes.

    PubMed

    Renz, M; Reichmuth, O; Bueche, D; Traichel, B; Mao, M Schuett; Cerny, T; Strasser, F

    2017-01-01

    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. 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. 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 process. Approaching death seems not only

  8. Environmental input and cognitive growth: a study using time-period comparisons.

    PubMed

    Huttenlocher, J; Levine, S; Vevea, J

    1998-08-01

    In this study, we examined the relation of input to cognitive growth in a single population of children. We studied 4 domains: Language, Spatial Operations, Concepts, and Associative Memory. Four groups of children drawn from the same population were tested in October of kindergarten, April of kindergarten, October of first grade, and April of first grade. These time points are 6 months apart, but they span periods that differ in amount of school input children receive. Much greater growth was found over time periods with greater amounts of school input (October to April) than over time periods with less school input (April to October) for Language, Spatial Operations, and Concepts, but not for Associative Memory. These findings suggest that amount of input is causally related to cognitive growth in particular domains.

  9. Death and Dying in Young Adult Fiction.

    ERIC Educational Resources Information Center

    Harvey, Carolyn; Dowd, Frances S.

    1993-01-01

    Reports on a content analysis study of 25 novels about youth facing death and dying to determine whether death and grieving are realistically portrayed in young adult literature. Describes the evaluative instruments developed and discusses findings, concluding that young people can be informed and comforted by these realistic novels. (38…

  10. End-of-life care and circumstances of death in patients dying as a result of cancer in Belgium and the Netherlands: a retrospective comparative study.

    PubMed

    Meeussen, Koen; Van den Block, Lieve; Echteld, Michael A; Boffin, Nicole; Bilsen, Johan; Van Casteren, Viviane; Abarshi, Ebun; Donker, Gé; Onwuteaka-Philipsen, Bregje; Deliens, Luc

    2011-11-10

    To examine and compare end-of-life care in patients with cancer dying in Belgium and the Netherlands. A mortality follow-back study was undertaken in 2008 via representative nationwide sentinel networks of general practitioners (GPs) in Belgium and the Netherlands. By using similar standardized procedures, GPs reported on aspects of end-of-life care and the circumstances of nonsudden death of patients with cancer in their practice. Of the 422 reported patients with cancer, most resided at home during the last year of life (Belgium, 91%; the Netherlands, 95%). Death occurred at home in 34% (Belgium) and 61% (the Netherlands) and in the hospital in 29% (Belgium) and 19% (the Netherlands). In the last month of life, end-of-life issues were more often discussed in the Netherlands (88%) than in Belgium (68%). In both countries, physical problems were discussed most often (Belgium, 49%; the Netherlands, 78%) and spiritual issues least often (Belgium, 20%; the Netherlands, 32%). Certain end-of-life treatment preferences were known for 43% (Belgium) and 67% (the Netherlands) of patients. In the last week of life, treatment was most often focused on palliation (Belgium, 94%; the Netherlands, 91%). Physical distress was reported in 84% (Belgium) and 76% (the Netherlands) of patients and psychological distress in 59% and 36%. Most distressing was lack of energy (Belgium, 73%; the Netherlands, 71%) and lack of appetite (Belgium, 61%; the Netherlands, 53%). Two thirds of patients were bedridden (Belgium, 67%; the Netherlands, 69%). Although place of death and communication about end-of-life issues differ substantially, a palliative treatment goal is adopted for the vast majority of patients in both countries. However, GPs reported that the majority of patients experienced symptom distress at the end of life, which suggests important challenges remain for improving end-of-life care.

  11. End-of-life care for people dying with dementia in general practice in Belgium, Italy and Spain: A cross-sectional, retrospective study.

    PubMed

    Penders, Yolanda W H; Albers, Gwenda; Deliens, Luc; Miccinesi, Guido; Vega Alonso, Tomás; Miralles, Maite; Moreels, Sarah; Van den Block, Lieve

    2017-01-06

    To describe and compare end-of-life care for people with mild or severe dementia in general practice in Belgium, Italy and Spain, in terms of place of care, place of death, treatment aims, use of specialized palliative care and communication with general practitioners (GPs). Cross-sectional retrospective survey was carried out of nationwide networks of GPs in Belgium, Italy and Spain, including patients who died aged 65 years or older in 2009-2011 and were judged by the GP to have had dementia (n = 1623). GPs reported a higher proportion of older people with severe dementia in Belgium (55%) than in Spain (46 %) and Italy (45 %), and a higher proportion of patients living in care homes (57% vs 18% and 13%, respectively). A palliative treatment aim was common in the last 3 months of life in all three countries. Specialized palliative care services were provided in 14% (Italy, severe dementia) to 38% (Belgium, severe dementia) of cases. Communication between GP and patient about illness-related topics occurred in between 50% (Italy) and 72% (Belgium) of cases of mild dementia, and 10% (Italy) to 32% (Belgium) of cases of severe dementia. Patient preferences for end-of-life care were known in a minority of cases. Few people (13-15 %) were transferred between care settings in the last week of life. Although overall treatment aims at the end of life are often aligned with a palliative care approach and transfer rates are low, there is room for improvement in end-of-life care for people with dementia in all countries studied, especially regarding early patient-GP communication. Geriatr Gerontol Int 2017; ••: ••-••. © 2017 Japan Geriatrics Society.

  12. The Japan HOspice and Palliative Care Evaluation Study (J-HOPE Study): views about legalization of death with dignity and euthanasia among the bereaved whose family member died at palliative care units.

    PubMed

    Okishiro, Nao; Miyashita, Mitsunori; Tsuneto, Satoru; Sato, Kazuki; Shima, Yasuo

    2009-01-01

    There has been a debate in appropriateness of legalization of death with dignity and euthanasia in Japan. To clarify views about these issues, we conducted a large nationwide study of the bereaved whose family member died at palliative care units. The percentages of 429 bereaved family members (response rate 65%) who affirmed legal authorization were 52 for death with dignity and 45 for euthanasia and who affirmed assignment at the discretion of the physician involved were 37 for death with dignity and 38 for euthanasia. In conclusion, views about legalization of death with dignity and euthanasia among the bereaved are inconsistent. No consensus is reached as to legislation of these issues.

  13. 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.

  14. Porcelain shoulder adaptation using direct refractory dies.

    PubMed

    Schneider, D M; Levi, M S; Mori, D F

    1976-11-01

    Eleven direct refractory dies were made from separate polysulfide rubber impressions of two Dentoform teeth which had been prepared for porcelain-fused-to-gold veneer crowns with labial porcelain shoulders. Porcelain veneer crowns were built and fired directly on the dies, following the manufacturer's instructions and using a common laboratory technique. The finished crowns were seated on the Dentoform teeth, and the porcelain-tooth adaptation was measured with a micrometer eyepiece in a dissecting microscope. In general, the study indicated that by use of a direct refractory die, the porcelain adaptation of an average porcelain shoulder veneer crown could be made to fall within the tolerances of a clinically acceptable gold margin (39 mu).21 The crown could likewise be made to adapt closer than the normal thickness of cement film may allow (20 to 40 mu).22 However the adaptation of many crowns was more uneven than the above statements would tend to indicate. The study also showed that with great care and a limited number of firings, margins of a lesser thickness than a piece of 0.001 inch (25.4 mu) platinum foil could be attained. There appears to be promise in the use of a direct refractory die material. However, more studies are needed to overcome some of the problems in the technique described.

  15. A New Method for Studying the Periodic System Based on a Kohonen Neural Network

    ERIC Educational Resources Information Center

    Chen, David Zhekai

    2010-01-01

    A new method for studying the periodic system is described based on the combination of a Kohonen neural network and a set of chemical and physical properties. The classification results are directly shown in a two-dimensional map and easy to interpret. This is one of the major advantages of this approach over other methods reported in the…

  16. A New Method for Studying the Periodic System Based on a Kohonen Neural Network

    ERIC Educational Resources Information Center

    Chen, David Zhekai

    2010-01-01

    A new method for studying the periodic system is described based on the combination of a Kohonen neural network and a set of chemical and physical properties. The classification results are directly shown in a two-dimensional map and easy to interpret. This is one of the major advantages of this approach over other methods reported in the…

  17. Extended AB period study of the electron pairing transition in t-J ladders

    SciTech Connect

    Kusakabe, Koichi; Aoki, Hideo

    1996-11-01

    The extended Aharonov-Bohm period test, recently proposed by the present authors, is used to study the electron pairing transition in the t-J ladders. The critical point is detected as a gap opening in the extended spectral flow. The result suggests a pairing prior to the onset of a phase separation, which is consistent with a recent Tomonaga-Luttinger analysis.

  18. Study on the Geomagnetic Short Period Variations of the Northwestern Yunnan

    NASA Astrophysics Data System (ADS)

    Yuan, Y.; Li, Q.; Cai, J.

    2015-12-01

    The Northwestern Yunnan is located in the interaction area between the Eurasian plate and the India plate. This area has been the ideal place for the research of continental dynamics and the prediction for risk region of strong earthquake for its complex tectonic environment and frequent seismic activity. Therefore the study on the geomagnetic short period variations is of great significance in the exploration of deep electrical structure, analysis of the seismic origin and deep geodynamics in the Northwestern Yunnan of China . This paper is based on the geomagnetic data from the magnetometer array with 8 sites built in the northwestern Yunnan to explore the deep electrical structure by the method of geomagnetic depth sounding. Firstly, we selected a total of 183 geomagnetic short period events at the range of 6min to 120min period. And we found a north northwest dividing line, of which two sides has the opposite value in the vertical component variation amplitude, which indicates the obvious conductivity anomaly underground. Secondly, the contour maps of the ratio of vertical component and horizontal component variation amplitude ΔZ/ΔH in different periods reflects the changes of a high conductivity belt's direction and position. In addition, the induction arrows maps within the period of 2 - 256min also shows that on the two sides of the dividing line the induction vectors deviate from each other, and the amplitude and direction of vectors varies with periods regularly. In the light of this, we infer that a high conductivity belt probably exists, which stretches from the deep crust to uppermost mantle and changes with depth constantly with the reference of magnetotelluric sounding. In the end of this paper, the staggered grid finite difference method is used to model the simplified three-dimensional high conductivity anomaly, and the result shows magnetic field distributions are consistent with the observed geomagnetic short period variations characteristics in

  19. Doubly periodic structure for the study of inhomogeneous bulk fermion matter with spatial localizations

    SciTech Connect

    Vantournhout, Klaas; Jachowicz, Natalie; Ryckebusch, Jan

    2011-09-15

    We present a method that offers perspectives to perform fully antisymmetrized simulations for inhomogeneous bulk fermion matter. The technique bears resemblance to classical periodic boundary conditions, using localized single-particle states. Such localized states are an ideal tool to discuss phenomena where spatial localization plays an important role. The antisymmetrization is obtained introducing a doubly periodic structure in the many-body fermion wave functions. This results in circulant matrices for the evaluation of expectation values, leading to a computationally tractable formalism to study fully antisymmetrized bulk fermion matter. We show that the proposed technique is able to reproduce essential fermion features in an elegant and computationally advantageous manner.

  20. Caring for a dying spouse at the end of life: 'It's one of the things you volunteer for when you get married': a qualitative study of the oldest carers' experiences.

    PubMed

    Turner, Mary; King, Claire; Milligan, Christine; Thomas, Carol; Brearley, Sarah G; Seamark, David; Wang, Xu; Blake, Susan; Payne, Sheila

    2016-05-01

    older people aged 80 and over are increasingly providing end-of-life care to spouses at home and often do so for long periods of time, while also trying to manage their own illnesses and disabilities. Little of the research on older spousal carers has focussed on the oldest carers; hence, the needs of this particular population are not fully known. to explore the experiences of the 'oldest carers' in caring for a dying spouse at home. secondary analysis was undertaken on a subset of data from a larger qualitative interview study; this dataset comprised 17 interviews from participants aged 80 or over. Framework analysis methods were used, with items derived from the thematic analysis of the main study. the oldest carers in this subset demonstrated high levels of resilience and the ability to adapt to their caring role. Caring until death was accepted as an integral part of the commitment made to their partner as part of the 'wedding contract'. Carers felt they benefitted from the support provided by family, friends and care services; however, their own care needs were not always recognised by health and social care services. these findings underscore the complexity of the oldest carers' experiences and challenges in times of illness and end of life. Healthcare professionals should be alerted to the myriad ways caregiving is enacted in serious illness and seek opportunities for developing supportive interventions specifically for older carers. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Study of the period changes in SW Dor, an RR Lyrae type star with Blazhko effect

    NASA Astrophysics Data System (ADS)

    Berdnikov, L. N.; Kniazev, A. Y.; Dambis, A. K.; Kravtsov, V. V.; Sefako, R.

    2016-09-01

    In 2012-2014 we acquired 1569 CCD BVIc frames for the RR Lyrae type variable SW Dor with the 76-cm telescope of the South African Astronomical Observatory (SAAO) and 1-m telescopes of Las Cumbres Observatory Global Telescope network (LCOGT). Our observations showed a large scatter in the resulting phased light curve, especially near maximum brightness, which allowed us to reveal the Blazhko effect with a period of ˜80.9d. To study the pulsation period changes, we used all the available observations including the 1299 magnitude estimates from the digitized plate library of Harvard University (the DASCH project), which allowed us to construct the O-C diagram spanning a 125-year long time interval and discover for the first time at least three abrupt changes of the pulsation period.

  2. Ionic adsorption on the brucite (0001) surface: A periodic electrostatic embedded cluster method study

    NASA Astrophysics Data System (ADS)

    Makkos, Eszter; Kerridge, Andrew; Austin, Jonathan; Kaltsoyannis, Nikolas

    2016-11-01

    Density functional theory (DFT) at the generalised gradient approximation level is employed within the periodic electrostatic embedded cluster method (PEECM) to model the brucite (0001) surface. Three representative studies are then used to demonstrate the reliability of the PEECM for the description of the interactions of various ionic species with the layered Mg(OH)2 structure, and its performance is compared with periodic DFT, an approach known to be challenging for the adsorption of charged species. The adsorption energies of a series of s block cations, including Sr2+ and Cs+ which are known to coexist with brucite in nuclear waste storage ponds, are well described by the embedded cluster model, provided that basis sets of triple-zeta quality are employed for the adsorbates. The substitution energies of Ca2+ and Sr2+ into brucite obtained with the PEECM are very similar to periodic DFT results, and comparison of the approaches indicates that two brucite layers in the quantum mechanical part of the PEECM are sufficient to describe the substitution. Finally, a detailed comparison of the periodic and PEECM DFT approaches to the energetic and geometric properties of differently coordinated Sr[(OH)2(H2O)4] complexes on brucite shows an excellent agreement in adsorption energies, Sr-O distances, and bond critical point electron densities (obtained via the quantum theory of atoms-in-molecules), demonstrating that the PEECM can be a useful alternative to periodic DFT in these situations.

  3. Multiperiodicity in quasi-periodic pulsations of flare hard X-rays: a case study

    NASA Astrophysics Data System (ADS)

    Tomczak, M.; Szaforz, Ż.

    We present a case study of the solar flare (SOL2001-10-02T17:31) that showed quasi-periodic pulsations (QPPs) in hard X-rays with two simultaneously excited periods, P_1 = 26-31 s and P_2 = 110 s. Complete evolution of the flare recorded by the Yohkoh telescopes, together with the patrol SOHO/EIT images, allowed us to identify magnetic structures responsible for particular periods and to propose an overall scenario which is consistent with the available observations. Namely, we suggest that emerging magnetic flux initiated the reconnection with legs of a large arcade of coronal loops that had been present in an active region for several days. The reconnection excited MHD oscillations in both magnetic structures simultaneously: period P_1 was generated in the emerging loop and in a loop being a result of the reconnection; period P_2 occurred in the arcade. Both resonators produced photons of different spectra. We anticipate that multiperiodicity in hard X-rays can be a common feature of flare hybrids, i.e. the events, in which magnetic structures of different sizes interact.

  4. Do periodic arm movements during sleep exist in healthy subjects? A polysomnographic study.

    PubMed

    Gabelia, David; Mitterling, Thomas; Högl, Birgit; Wenning, Gregor K; Frauscher, Birgit

    2014-09-01

    Despite several polysomnographic studies on periodic leg movements (PLM) in healthy sleep, data on the prevalence and characteristics of periodic arm movements (PAM) in normal subjects are lacking. We aimed to investigate PAM and their association with PLM during wakefulness and sleep in healthy subjects. Ninety-one participants underwent video-polysomnography according to American Academy of Sleep Medicine 2007 criteria. In addition to standard electromyographic registration, data for both flexor digitorum superficialis muscles were recorded. Sixty-two subjects (68.1%) had a PAM index during wakefulness >5/h (median PAM index during wakefulness, 8.8/h; range, 0-77). Seven subjects (7.7%) had a PAM index >5/h during sleep (median PAM index during sleep, 0.7/h; range, 0-47.4). In 14% of cases, PAM during wakefulness were coincident with PLM during wakefulness. During sleep, this coincidence was not evident. The correlation between PAM and PLM was weak to moderate (during wakefulness: Spearman's ρ = 0.576, P < 0.001; during sleep: Spearman's ρ = 0.222, P = 0.036). In healthy subjects, PAM occur predominantly during wakefulness with no apparent true periodicity. In contrast to classical PLM, some PAM may not present a true periodic phenomenon, but rather random voluntary movements meeting the wide range of periodicity criteria for PLM. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  5. Die Sonne, Stern unserer Erde

    NASA Astrophysics Data System (ADS)

    Lang, Kenneth R.; Ehlers, A.

    Dieses reich bebilderte Buch gibt eine Einführung in die Physik der Sonne und ihre Bedeutung für die Erde. Gestützt auf neueste Forschungsergebnisse aus Radioteleskop- und Satellitenbeobachtungen beschreibt der Autor die gewaltigen atomenergetischen Prozesse der Sonne, ihren geheimnisvollen Neutrinofluß, ihre seismischen Aktivitäten, Magnetfelder und Sonnenflecke, Korona, Sonnenausbrüche und Protuberanzen, den Sonnenwind, und die außerordentlich wichtige und vielfältige Bedeutung des Sonnenlichts, das Leben auf der Erde entstehen läßt und es auch gefährdet. Gut verständlich und in ansprechender Sprache geschrieben ist es ein wunderbares Buch für den Leser populärwissenschaftlicher Literatur, ein wertvolles Geschenk für Studenten der Astronomie und verwandter Disziplinen sowie Amateurastronomen.

  6. "Sometimes I've gone home feeling that my voice hasn't been heard": a focus group study exploring the views and experiences of health care assistants when caring for dying residents.

    PubMed

    Fryer, Susan; Bellamy, Gary; Morgan, Tessa; Gott, Merryn

    2016-08-19

    In most developed countries, Health Care Assistants comprise a significant, and growing, proportion of the residential aged care workforce. Despite the fact that they provide the majority of direct care for residents, little is known about a key care aspect of their work, namely their experience of caring for dying residents. Twenty-six Health Care Assistants working in aged residential care facilities in Auckland, New Zealand participated in six focus group discussions. Focus groups were designed to explore the experiences of Health Care Assistants caring for imminently dying residents in aged care facilities and to identify barriers and facilitators to their work in this area. The focus groups were digitally recorded, transcribed verbatim and analysed using a general inductive approach. Participants confirmed that Health Care Assistants provide the majority of hands on care to dying residents and believed they had a valuable role to play at this time due to their unique 'familial' relationship with residents and families. However, it was apparent that a number of barriers existed to them maximising their contribution to supporting dying residents, most notably the lack of value placed on their knowledge and experience by other members of the multidisciplinary team. Whilst a need for additional palliative and end of life care education was identified, a preference was identified for hands on education delivered by peers, rather than the didactic education they currently receive. Given ageing populations internationally coupled with a constrained health budget, the role of Health Care Assistants in most developed countries is likely to become even more significant in the short to medium term. This study makes a unique contribution to the international literature by identifying the barriers to caring for dying residents experienced by this valuable sector of the aged care workforce. These data have the potential to inform new, innovative, interventions to address

  7. 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.

  8. Heat treatment of forging dies

    NASA Astrophysics Data System (ADS)

    Dovnar, S. A.; Kadnikov, S. A.

    1987-08-01

    In forging-die production there is a considerable range of forging dies which are promising for a changeover into advanced heat treatment involving bulk temper hardening and surface hardening using induction heating. The heat treatment suggested provides a saving of material resources as a result of improving the life of forging dies by a factor of 1.5-3 depending on the grade of die steel. As a result of induction hardening of forging dies, after temper hardening close to the boundary of the hardened layer a zone of reduced hardness forms whose unfavorable effect may be reduced by using before induction surface hardening bulk warming in a furnace or deep induction heating with a reduced energy concentration in the heating zone to the tempering temperature in the temper hardening cycle. In order to improve the uniformity of induction surface hardening for dies with a complex working shape it is desirable to use heating at reduced power with an increase in heating time.

  9. Measuring rotation periods of solar-like stars using TIGRE. A study of periodic CaII H+K S-index variability

    NASA Astrophysics Data System (ADS)

    Hempelmann, A.; Mittag, M.; Gonzalez-Perez, J. N.; Schmitt, J. H. M. M.; Schröder, K. P.; Rauw, G.

    2016-02-01

    Context. The rotation period of a star is a key parameter both for the stellar dynamo that generates magnetic fields as well as for stellar differential rotation. Aims: We present the results from the first year of monitoring a sample of solar-like stars by the TIGRE facility in Guanajuato (Mexico), which will study rotation in solar analogs. Methods: TIGRE is an automatically operating 1.2 m telescope equipped with an Échelle spectrograph with a spectral resolution of 20 000, which covers a spectral range of between 3800 and 8800 Å. A main task is the monitoring the stellar activity of cool stars, mainly in the emission cores of the CaII H and K lines. We observed a number of stars with a sampling between 1-3 days over one year. Results: A total number of 95 stars were observed between August 1 2013 and July 31 2014, the total number of spectra taken for this program was appoximately 2700. For almost a third of the sample stars the number of observations was rather low (less than 20), mainly because of bad weather. Fifty-four stars show a periodic signal but often with low significance. Only 24 stars exhibit a significant period. We interpret these signals as stellar rotation. For about half of them the rotation periods were already previously known, in which case our period measurements are usually in good agreement with the literature values. Besides the periodic signals, trends are frequently observed in the time series. Conclusions: TIGRE is obviously able to detect stellar rotation periods in the CaII H+K emission cores when the time series contains a sufficient number of data points. However, this is frequently not achievable during the wet summer season in Guanajuato. Hence, future estimates of rotation periods will concentrate on stars that are observable during the winter season from October until April.

  10. Microstructure and corrosion behavior of die-cast AM60B magnesium alloys in a complex salt solution. A slow positron beam study

    SciTech Connect

    Liu, Y. F.; Yang, W.; Qin, Q. L.; Wen, W.; Zhai, T.; Yu, B.; Liu, D. Y.; Luo, A.; Song, GuangLing

    2013-12-15

    The microstructure and corrosion behavior of high pressure die-cast (HPDC) and super vacuum die-cast (SVDC) AM60B magnesium alloys were investigated in a complex salt solution using slow positron beam technique and potentiodynamic polarization tests. The experiments revealed that a CaCO3 film was formed on the surface of the alloys and that the rate of CaCO3 formation for the SVDC alloy with immersion time was slower than that of the HPDC alloy. The larger volume fraction of b-phase in the skin layer of the SVDC alloy than that of the HPDC alloy was responsible for the better corrosion resistance.

  11. A study on the effect of exclusion period on the suicidal risk among the insured.

    PubMed

    Yip, Paul S F; Chen, Feng

    2014-06-01

    An exclusion period (usually from 12 months to 2 years) is usually found in life insurance policies as a precautionary measure to prohibit people from insuring their lives with the intent to kill themselves shortly thereafter. Several studies have been conducted to investigate the effect of exclusion periods on the risk of suicide among the insured in the US and Australia. However, while Hong Kong has experienced an increase in the number of suicides among the insured, little is known about the dynamic between the exclusion period and suicide in Asia. Here we make use of death claims data from one of the major life insurance companies in Hong Kong to ascertain the impact of a 12-month exclusion period on suicide risk. We also use utility functions derived from economic theory to better understand individual choices regarding suicide among the insured. More specifically, we sought to determine whether there is a greater risk of suicide immediately following the 12-month exclusion period. We also examined whether the risk of suicide claims was higher than that of other non-suicidal claims. The study period for this investigation was from January 1, 1997 to December 31, 2011, during which time there were 1935 claims based on 1243 deaths. Of these, 197 were suicide-related claims for 106 suicide deaths. The mean number of life policies held by suicidal claimants and non-suicidal claimants was 1.6 and 1.4, respectively. The average/median size of the claims (total payment made on all policies held by the insured life) was HK$665,800/426,600 and HK$497,700/276,200 for suicidal and non-suicidal deaths, respectively. The policy lifetime of the claims, or the number of days from policy issuance to suicide occurrence, ranged from 38 to 7561 days, with a mean of 2209 days, a median of 1941 days, and a standard deviation of 1544 days. The peak density of suicide claims occurred on day 1039 of the policy. Our results revealed that suicide claims tend to occur earlier than other

  12. 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.

  13. 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…

  14. Personality Correlates of the Fear of Death and Dying Scale.

    ERIC Educational Resources Information Center

    Loo, Robert

    1984-01-01

    Examined personality dimensions of the Fear of Death and Dying Scale compared to the Eysenck Personality Questionnaire in a study of 88 students. Findings supported the validity of the Fear of Death and Dying Scale and its independence of social desirability. (JAC)

  15. 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…

  16. 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…

  17. Potato Early Dying: Molecular Perspectives on Pathogenicity and Host Resistance

    USDA-ARS?s Scientific Manuscript database

    Potato early dying has not received the reputation of being a particularly devastating disease of potato. However, the interaction between the vascular fungus Verticillium dahliae and the root lesion nematode Pratylenchus penetrans to form the early dying complex makes studying this disease very in...

  18. 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…

  19. Thoughts about Death and Dying in an African Sample.

    ERIC Educational Resources Information Center

    Gijana, E. W. M.; And Others

    1990-01-01

    Examined attitudes toward death and dying among 163 Xhosa-speaking children and adults in South Africa. Found age, gender, belief in life after death, educational level, and exposure to death and dying were critical factors in formation of attitudes. Findings were similar to those from previous studies in African and western societies. (Author/NB)

  20. Retrospective observation of mental disorders during postpartum period: Results from the Singapore mental health study.

    PubMed

    Sagayadevan, Vathsala; Lee, Siau Pheng; Abdin, Edimansyah; Vaingankar, Janhavi; Chen, Helen; Chong, Siow Ann; Subramaniam, Mythily

    2015-12-16

    The perinatal period has been identified as a period of vulnerability for various disorders (particularly anxiety and depressive disorders), which have been associated with negative outcomes for both mother and infant. The current study utilized data from the Singapore Mental Health Study (SMHS) to examine the temporal relationship between mental disorders and the perinatal period, as well as associated risk factors. Life table estimation method was used to derive the estimated hazard rate for any mood or anxiety disorders following pregnancy. Multivariate logistic regression was used to examine the association between socio-demographic factors and onset of mental disorders after the first pregnancy. Among women with children (n = 2278), 1.5 % were found to have an onset of any mental disorder (i.e., mood disorders, anxiety disorders, alcohol use disorders), within 2 years after pregnancy. A peak in hazard rate was noted at approximately 1 year following pregnancy for anxiety disorders but not mood disorders. Women who were married, employed and physically healthy were less likely to have had developed any mental disorder. The prevalence of mental disorders during pregnancy and postpartum was found to be low among women with children in our community sample, with increased vulnerability following delivery. The results offer some insight into the occurrence of mental disorders during the perinatal period among women in Singapore.

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

    DTIC Science & Technology

    1981-08-01

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

  2. Experience in cochlear reimplantation. Descriptive study of a 20-year period.

    PubMed

    Gutiérrez-Salazar, Andrés; Cop, Constanze; Osorio-Acosta, Ángel; Borkoski-Barreiro, Silvia; Falcón-González, Juan C; Ramos-Macías, Ángel

    2015-01-01

    The cochlear implant is a surgical procedure that has increased substantially, because the paediatric population is diagnosed and implanted early and because there are increased potential indications. This device has the inherent risk of failure in performance, as dies any active medical device, which is the most common cause of implant removal. Our goal was to understand what the causes that produced removal in our series were, and confirm if these conformed to reality as reviewed in the literature. This was a retrospective, descriptive, observational study of 859 cochlear implant surgeries carried out between October 1991 and May 2011. The causes of implant removal were classified according to the European Consensus Statement on Cochlear Implant Failures and Explantations. The reimplantation rate was 6.16% (n=51). The most common reason for removal was technical device failure (45.5%), followed by infection/rejection (23.6%) and upgrade (12.7%). Less common causes: there were 3 cases (5.6%) of electrode misplacement, 2 cases (3.6%) of labyrinthine ossification, 2 (3.6%) as a result of head trauma, 2 (3.6%) from need for nuclear magnetic resonance imaging and 1 case (1.8%) from psychiatric illness. Cochlear reimplantation is a safe procedure, with a low complication rate. In our centre, it reaches an overall rate of 6.16%. Technical device failure remains the most common cause of this procedure, although there is a significant percentage of reimplantation for device update. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

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

    PubMed

    Tan, Amy; Manca, Donna

    2013-01-22

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

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

    PubMed Central

    2013-01-01

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

  5. A study of the shortest-period planets found with Kepler

    SciTech Connect

    Sanchis-Ojeda, Roberto; Rappaport, Saul; Winn, Joshua N.; Kotson, Michael C.; Levine, Alan; Mellah, Ileyk El E-mail: sar@mit.edu E-mail: ileyk@apc.univ-paris7.fr

    2014-05-20

    We present the results of a survey aimed at discovering and studying transiting planets with orbital periods shorter than one day (ultra-short-period, or USP, planets), using data from the Kepler spacecraft. We computed Fourier transforms of the photometric time series for all 200,000 target stars, and detected transit signals based on the presence of regularly spaced sharp peaks in the Fourier spectrum. We present a list of 106 USP candidates, of which 18 have not previously been described in the literature. This list of candidates increases the number of planet candidates with orbital periods shorter than about six hours from two to seven. In addition, among the objects we studied, there are 26 USP candidates that had been previously reported in the literature which do not pass our various tests. All 106 of our candidates have passed several standard tests to rule out false positives due to eclipsing stellar systems. A low false positive rate is also implied by the relatively high fraction of candidates for which more than one transiting planet signal was detected. By assuming these multi-transit candidates represent coplanar multi-planet systems, we are able to infer that the USP planets are typically accompanied by other planets with periods in the range 1-50 days, in contrast with hot Jupiters which very rarely have companions in that same period range. Another clear pattern is that almost all USP planets are smaller than 2 R {sub ⊕}, possibly because gas giants in very tight orbits would lose their atmospheres by photoevaporation when subject to extremely strong stellar irradiation. Based on our survey statistics, USP planets exist around approximately (0.51 ± 0.07)% of G-dwarf stars, and (0.83 ± 0.18)% of K-dwarf stars.

  6. Retrospective study of recession of four horizontal rectus muscle in periodic alternating nystagmus

    PubMed Central

    Mimura, Osamu; Ishikawa, Hiroto; Kimura, Naoki; Kimura, Akiko; Borlongan, Cesar V

    2014-01-01

    Purpose Periodic alternating nystagmus (PAN) is a spontaneous horizontal nystagmus observed in disorders of the central nervous system. Patients with congenital PAN complain of oscillating vision at high rates. Medication is the first-choice treatment for PAN; however, clinicians still seek better therapy. The aim of this study was to evaluate outcomes of recession of four horizontal rectus muscle (R-FHR) in patients with congenital PAN. Patients and methods This study reports a retrospective case series of ten patients (seven males and three females; mean age 24.4±10.9) with congenital PAN who underwent R-FHR between 2007 and 2012, which was performed by the same surgeon at the Hyogo College of Medicine. Patients were evaluated for complications, recession amount, deviation angle, eye movements including a nystagmus amplitude, and visual acuity during pre- and post-operative periods. Results Pre-operatively, patients complained of oscillating vision, abnormal head posture, esotropia, and congenital superior oblique palsy. Post-operatively, changes from the previous observations of nystagmus amplitudes and abnormal head posture demonstrated a complete reversal in all patients. In addition, visual acuity determined with a Snellen chart improved in two patients. However, esotropia occurred in three patients who underwent additional strabismus surgery 2 days after R-FHR. R-FHR was particularly effective in eight patients who pre-operatively had periodic oscillating vision with a regular pattern of periodic nystagmus. Conclusion We demonstrated that ten patients with congenital PAN had improved vision following R-FHR, indicating that R-FHR was an effective procedure, especially in patients suffering PAN with periodic oscillating vision. PMID:25525330

  7. Frequent use of hospital inpatient services during a nine year period: a retrospective cohort study.

    PubMed

    Springer, Adelle M; Condon, John R; Li, Shu Q; Guthridge, Steven L

    2017-05-12

    Frequent use (FU) of hospital services impacts on patients and health service expenditure. Studies examining FU in emergency departments and inpatient settings have found heterogeneity and the need to differentiate between potentially preventable FU and that associated with ongoing management of complex conditions. Psychosocial factors have often been reported as underpinning or exacerbating the phenomena. Most FU studies have been limited by time, to a single study site, or restricted to specific diagnoses or patient groups. This study provides a comprehensive description of adult patient characteristics, conditions and risk factors associated with FU, based on admissions to the five public hospitals in the Northern Territory (NT) of Australia over a nine year period. The study population is distinctive comprising both Aboriginal and non-Aboriginal patients. Data on all inpatient episodes in NT public hospitals between 2005 and 2013 was analysed to identify patients with any FU (four or more episodes within any 12-month period) and measure FU duration (number of FU years) and intensity (mean number of episodes per FU year). Pregnancy, alcohol-related and mental health condition flags were assigned to patients with any episode with relevant diagnoses during the study period. Multivariate analysis was used to assess factors associated with any FU, FU duration and FU intensity, separately for Aboriginal and non-Aboriginal patients. Of people with any inpatient episodes during the study period, 13.6% were frequent users (Aboriginal 22%, non-Aboriginal 10%) accounting for 46.6% of all episodes. 73% of frequent users had only one FU year. Any FU and increased FU duration were more common among individuals who were: Aboriginal; older; female; and those with a pregnancy, alcohol or mental health flag. Having two or more alcohol-related episodes in the nine-year period was strongly associated with any FU for both Aboriginal (odds ratio 8.9, 95% CI. 8.20-9.66) and non

  8. A Centennial Period Study of V523 Cassiopeiae: Nearly 100 years of Eclipse Timings

    NASA Astrophysics Data System (ADS)

    Samec, R. G.; Banks, D. W.; Hernandez, R. B.; Bright, L. A.; Faulkner, D. R.; Williams, D. B.

    1999-05-01

    V523 Cassiopeiae has figured prominently in studies of very short period K-type nondegenerate eclipsing binaries over the past 15 years. It has one of the shortest orbital periods among such binaries, P = 336.5 minutes. Roche-lobe contact light curve solutions do not allow mass ratios near that determined from its radial velocity curve (qsp=0.42). It is also known to have a changing orbital period. BBSAG as well as other observers have patrolled this system over the past decade or so, observing hundreds of eclipse timings. In this paper we reveal 50 times of low light found from an archival search of Harvard plate stacks (DBW) in the interval from 1901 to 1942. We also present Johnson UBV light curves taken with the Lowell 0.79m reflecting telescope on the nights of 1998 September 15 to 17 (DRF). Six precision mean epochs of minimum light: 2451071.6881(3), 2451071.8046(2), 2451072.7395(1), 2451072.8566(2), 2451073.7928(3) and 2451073.9081(1) were determined. Some 430 timings of minimum light were gathered for this period study, covering nearly 152,000 orbits. The O-C residual curve yields a sinusoidal variation with a amplitude of 0.040(8) days, and a period of 106(10) years, overlain upon a continuous period increase with a quadratic term of 1.1 X10-11 d/E2. Assuming that the periodic oscillation is due to a third star in the system, and the inclination from our orbital solution for the close pair is the same as the larger orbit, the third star is calculated to have 0.36 solar masses. This is similar to the masses of the stars that comprise the contact binary (0.88 solar masses). Thus, the entire system consists of a trio of late K and early M-type dwarfs, if this scenario is correct. A linear fit to recent timings yields the following ephemeris: J.D. Hel Min I = 2446708.7709(8) d + 0.23369222(7) X E. A simultaneous UBV synthetic light curve-radial velocity curve analysis is reported. Our small team of three undergraduate researchers performed most of the analyses

  9. Study of the resonances of periodic plane media immersed in water: theory and experiment.

    PubMed

    Khaled, Aissam; Maréchal, Pierre; Lenoir, Olivier; Ech-Cherif El-Kettani, Mounsif; Chenouni, Driss

    2013-03-01

    The paper deals with the study of the resonances of 1D periodic media composed of N elementary cells formed with two perfectly bonded layers which exhibit a high acoustic impedance contrast. In the case of a periodic bilayer structure constituted of a fluid layer and an elastic plate, it was shown in previous theoretical works that additional modes appear compared to those of a single plate. These are called structure modes. At low frequency, the so-called vertical modes are found. Approximate expressions of their cut-off frequencies are given and their numerical values match with the exact ones. At high frequency, the Lamb type modes are degenerated and modes in the fluid layers are also observed. Preliminary experimental results have already proved the existence of such phenomena for one and two periods. In our work, an experimental validation has been performed in the case of N periods made with a glass isotropic elastic plate and a water fluid layer, where the number N ranges from two to five. A good agreement is shown compared to theoretical works.

  10. A study on characteristics of Methane emission from a periodically irrigated paddy field in Japan

    NASA Astrophysics Data System (ADS)

    Wakikuromaru, N.; Iwata, T.; Yagi, K.

    2014-12-01

    Methane (CH4) is generated by organic matter decomposition in the anaerobic soil. Paddy field is one of the most important eco-system in monsoon Asia. It is said that about 10% of CH4sources is paddy fields (IPCC AR4, 2007). In this study, methane emission from a single-rice crop field was estimated by long-term micrometeorological measurements. Methane emission was calculated by the aerodynamic gradient technique from January 2011 to August 2014. Intermittent water management was carried out during cultivation period at the observational site, HCH, located in Okayama, Japan. 3-days flood and 4-days drained condition were regularly repeated from late-June to early October. Seasonal variations of CH4flux for irrigation term from 2011 to 2013 were shown in Fig.1. Remarkably large fluxes were shown at early stage of irrigation term in 2011.It seemed to be caused by the relatively longer flooded condition that the first flooded period was 20 days. Flux in 2012 was smaller than in other year through the entire irrigation period. Rapid rise in flux for early August and gradual decrease between late August and September were shown in 2013. Fluxes under drained condition showed larger emission than under flooded condition. Cumulative CH4 emissions during cultivated period from 2011 to 2013 were estimated 15.7, 8.6, and 12.9 gC/m2, respectively.

  11. Self-consistent simulation studies of periodically focused intense charged-particle beams

    SciTech Connect

    Chen, C.; Jameson, R.A.

    1995-09-01

    A self-consistent two-dimensional model is used to investigate intense charged-particle beam propagation through a periodic solenoidal focusing channel, particularly in the regime in which there is a mismatch between the beam and the focusing channel. The present self-consistent studies confirm that mismatched beams exhibit nonlinear resonances and chaotic behavior in the envelope evolution, as predicted by an earlier envelope analysis [C. Chen and R. C. Davidson, Phys. Rev. Lett. 72, 2195 (1994)]. Transient effects due to emittance growth are studied, and halo formation is investigated. The halo size is estimated. The halo characteristics for a periodic focusing channel are found to be qualitatively the same as those for a uniform focusing channel. A threshold condition is obtained numerically for halo formation in mismatched beams in a uniform focusing channel, which indicates that relative envelope mismatch must be kept well below 20% to prevent space-charge-dominated beams from developing halos.

  12. Mössbauer studies on ancient chinese pottery of Yangshao Culture Period

    NASA Astrophysics Data System (ADS)

    Yu, Zhengfang; Zheng, Qi; Zheng, Yufang

    1988-12-01

    Eleven pieces of ancient Chinese pottery (4770 B.C. 2960 B.C.) of Yangshao Culture Period collected from the Xi'an area have been studied by means of Mössbauer spectroscopy. The samples were refired up to 1100°C in steps of 100°C for 2h in air. The highest temperature up to which the Mössbauer pattern remains basically unchanged can be identified with the original firing temperature. The result indicates that the firing temperatures for most of the sherds were between 900 1000°C. The function of the grit contained in the pottery has been discussed. The crimson and reddish painted materials on the surface of sherds have been studied, respectively. The first appearance of pottery can probably be traced back to an even earlier period.

  13. 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.

  14. Study of biological rhythms of small intestinal cryptic epithelial mitosis of different periodicity by fourier analysis.

    PubMed

    Romanov, Yu A; Zharkova, N A; Antochin, A I; Zakharchenko, A V

    2009-05-01

    Rhythms of cell division with different periods in the mouse small intestinal cryptic epithelium were studied using Fourier analysis. It was found that the proliferative system of the crypt is characterized by an intricate spatial and temporal organization. The amplitude of low-frequency rhythms increases, while the amplitude of high-frequency rhythms decreased in the direction from the crypt bottom to the neck.

  15. A statistical study of short period waves in the ionosphere above Central Europe

    NASA Astrophysics Data System (ADS)

    Sindelarova, Tereza; Chum, Jaroslav; Mosna, Zbysek; Buresova, Dalia; Potuznikova, Katerina; Base, Jiri; Fiser, Jiri

    2015-04-01

    We present a statistical study of waves of periods 0.5-6 min that occurred in the ionosphere above the Czech Republic. The dataset covers one year period from April 2013 to March 2014. Data were obtained from Doppler ionospheric sounding. The sounding is based on measurements of frequency shift between the transmitted wave of a stable known frequency and the wave received after its reflection in the ionosphere. It is a suitable tool for observations of wave activity in the ionosphere, particularly in the period range up to 60 min. The main objective of the study was to find whether there exist a preferred season and time of the day in the occurrence of these waves. We identified altogether 247 events of duration between 1minute and 13 hours. The highest number of events occurred in September 2013 (44 events). Contrary, only 5 events appeared in May 2013. In the diurnal course, the waves tend to occur mainly between sunset and sunrise. The described diurnal variability can be to some measure explained by diurnal changes of electron concentrations in the ionosphere and consequent changes of the reflection height of the Doppler sounding wave. The 3.59 MHz radio wave usually reflects from the ionospheric F layer at night and from the E layer during the daytime. When the sounding wave reflects in the E region, it usually experiences zero or only negligible Doppler shift. Similarly, low number of events in May (and also in July) can be related with seasonal variability of electron concentration in the ionosphere. Sources of oscillations measured by the Doppler sounding system in the studied period range of 0.5-6 min include infrasound, geomagnetic micropulsations or transient changes of electron concentration caused by x-rays arrivals. We will present the interpretation of the statistical study with relation to the stated sources.

  16. Use of RSP Tooling to Manufacture Die Casting Dies

    SciTech Connect

    Kevin McHugh

    2004-07-01

    The technology and art used to construct die casting dies has seen many improvements over the years. However, the time lag from when a design is finalized to the time a tool is in production has remained essentially the same. The two main causes for the bottleneck are the need to qualify a part design by making prototypes (usually from an alternative process), and the production tooling lead time after the prototypes are approved. Production tooling costs are high due to the labor and equipment costs associated with transforming a forged block of tool steel into a finished tool. CNC machining, sink EDM, benching, engraving and heat treatment unit operations are typically involved. As a result, there is increasing interest in rapid tooling (RT) technologies that shorten the design-to-part cycle and reduce the cost of dies. There are currently more than 20 RT methods being developed and refined around the world (1). The "rapid" in rapid tooling suggests time compression for tool delivery, but does not address robustness as nearly all RT approaches are intended for low-volume prototype work, primarily for molding plastics. Few options exist for die casting. An RT technology suitable for production-quality tooling in the time it normally takes for prototype tooling is highly desirable. In fact, there would be no need for a distinction between prototype and production tooling. True prototype parts could be made using the same processing conditions and materials intended for production. Qualification of the prototype part would allow the manufacturer to go directly into production with the same tool. A relatively new RT technology, Rapid Solidification Process (RSP) Tooling, is capable of making production-quality tooling in an RT timeframe for die casting applications. RSP Tooling, was developed at the Idaho National Engineering and Environmental Laboratory (INEEL), and commercialized with the formation of RSP Tooling, LLC (2). This paper describes the process, and

  17. Perfusion index assessment during transition period of newborns: an observational study.

    PubMed

    Unal, Sezin; Ergenekon, Ebru; Aktas, Selma; Beken, Serdar; Altuntas, Nilgun; Kazanci, Ebru; Kulali, Ferit; Hirfanoglu, Ibrahim M; Onal, Esra; Turkyilmaz, Canan; Koc, Esin; Atalay, Yildiz

    2016-10-07

    Perfusion index (PI) is becoming a part of clinical practice in neonatology to monitor peripheral perfusion noninvasively. Hemodynamic and respiratory changes occur in newborns during the transition period after birth in which peripheral perfusion may be affected. Tachypnea is a frequent symptom during this period. While some tachypneic newborns get well in less than 6 h and diagnosed as "delayed transition", others get admitted to intensive care unit which transient tachypnea of newborn (TTN) being the most common diagnosis among them. We aimed to compare PI of neonates with TTN and delayed transition with controls, and assess its value on discrimination of delayed transition and TTN. Neonates with gestational age between 37 and 40 weeks who were born with elective caesarian section were included. Eligible neonates were monitored with Masimo Set Radical7 pulse-oximeter (Masimo Corp., Irvine, CA, USA). Postductal PI, oxygen saturation and heart rate were manually recorded every 10 s for 3 min for two defined time periods as 10(th) minute and 1(st) hour. Axillary temperature were also recorded. Newborn infants were grouped as control, delayed transition, and TTN. Forty-nine tachypneic (TTN; 21, delayed transition; 28) and 30 healthy neonates completed the study. PI values were similar between three groups at both periods. There were no correlation between PI and respiratory rate, heart rate, and temperature. PI assessment in maternity unit does not discriminate TTN from delayed transitional period in newborns which may indicate that peripheral perfusion is not severely affected in either condition.

  18. Which patients die in their preferred place? A secondary analysis of questionnaire data from bereaved relatives.

    PubMed

    Raijmakers, Natasja Jh; de Veer, Anke Je; Zwaan, Rosanne; Hofstede, Jolien M; Francke, Anneke L

    2017-06-01

    Previous studies on factors influencing the place of death have focused on cancer patients dying at home. However, home is not always the preferred place. To provide insight into the extent to which patients with various diseases die in their preferred place and into factors associated with dying in the preferred place. A secondary analysis of the data set of the evaluation study of the National Quality Improvement Programme for Palliative Care was undertaken to explore factors related to 'dying in the preferred place'. A total of 797 bereaved relatives filled in the Consumer Quality Index Palliative Care, a validated and reliable questionnaire. Two-thirds of the patients died in the preferred place. A preference for dying at home and having had a stroke decreased the likelihood of dying in the preferred place, while having a partner, dementia, contact with the general practitioner in the last week before death, and continuity of care between professionals increased the likelihood of dying in the preferred place. Furthermore, people who wanted to die at home and also had dementia were more likely to die elsewhere than people without dementia who wanted to die at home. Positive associations were found between continuity of care between healthcare professionals and contact with the general practitioner and the chance of people dying in their preferred place. Moreover, special attention for people who have had a stroke and for people with dementia who want to die at home seems indicated as their diagnosis is negatively associated with dying in their preferred place.

  19. Father mental health during the early parenting period: results of an Australian population based longitudinal study.

    PubMed

    Giallo, Rebecca; D'Esposito, Fabrizio; Christensen, Daniel; Mensah, Fiona; Cooklin, Amanda; Wade, Catherine; Lucas, Nina; Canterford, Louise; Nicholson, Jan M

    2012-12-01

    The primary objective of this study was to report on the occurrence of mental health difficulties for a large national sample of Australian fathers of children aged 0-5 years (n = 3,471). Secondary objectives were to compare fathers' mental health against normative data for the general male adult population, and to examine the course of mental health problems for fathers across the early childhood period. Secondary analysis of data from the infant cohort of the Longitudinal Study of Australian Children at three waves when children were 0-12 months, 2-3 and 4-5 years. Comparative data on the prevalence of psychological distress in the Australian adult male population sourced from the National Survey of Mental Health and Wellbeing. Approximately nine per cent of fathers reported symptomatic or clinical psychological distress at each wave, as measured by the Kessler-6. Approximately 30 % reporting distress at wave 1 continued to report distress at a similar or worse level across waves 2 and 3. Fathers not living with their children also had high rates of distress (14 % at wave 1 and 10 % at wave 2). Finally, fathers in the present study had 1.38 increased odds (95 % CI 1.12-1.69) for psychological distress compared with the Australian adult male population. Fathers are at risk of experiencing postnatal mental health difficulties, which may persist across the early childhood period for some fathers. The results suggest routine assessment of fathers' wellbeing should be undertaken in the postnatal period with mental health interventions and support provided across the early childhood period.

  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

    2017-02-22

    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.

  1. Investigation of contact pressure in auto panel drawing dies during the forming process by using FEM method

    NASA Astrophysics Data System (ADS)

    Koşar, Fatih; Yaman, Kemal

    2017-06-01

    In automotive stamping dies, the die design is generally based on experience. Usually, the loads on the die is not considered too much when the ribs, which strengthen the structure of the die, are positioned. Despite an abundance of manuscripts in the literature on formability and springback, the number of studies that examine the panel-die interaction is rather limited. The impact of the loads occurs in the form of contact pressure (CP) on the upper and lower die when the sheet metal is formed in a drawing die. For die designs, the CPs on the die must be calculated accurately in order to determine the correct position for the ribs and to optimize the weight of the die. The present study compares the CP distribution on a auto panel drawing die through different solution methods to examine the time-dependent change of the CP.

  2. On Flowfield Periodicity in the NASA Transonic Flutter Cascade. Part 1; Experimental Study

    NASA Technical Reports Server (NTRS)

    Lepicovsky, J.; McFarland, E. R.; Chima, R. V.; Wood, J. R.

    2000-01-01

    An extensive study to improve flow uniformity and periodicity in the NASA Transonic Flutter Cascade is presented here. The results are reported in two independent parts dealing with the experimental approach and the analytical approach. The first part, the Experimental Study, focuses first on the data sets acquired in this facility in the past and explains several discrepancies, particularly the questions of actual flow incidence and cascade back pressure levels. Next, available means for control and modifications of the cascade flowfield, boundary layer bleed and tailboard settings are presented in detail. This is followed by experimental data sets acquired in modified test facility configurations that were based on analytical predictions of the cascade flowfield. Finally, several important conclusions about improving the cascade flowfield uniformity and blade load periodicity are summarized. The important conclusions are: (1) boundary layer bleed does not improve the cascade flow periodicity; (2) tunnel wall contours must be carefully matched to the expected shape of cascade streamlines; (3) actual flow incidence for each cascade configuration rather must be measured instead of relying on the tunnel geometry; and (4) the current cascade configuration exhibits a very high blade load uniformity over six blades from blade #2 to blade #7, and the facility is now ready for unsteady pressure data acquisition.

  3. What Makes Vietnamese (Not) Attend Periodic General Health Examinations? A 2016 Cross-sectional Study

    PubMed Central

    Vuong, Quan-Hoang; Vu, Quang-Hoi; Vuong, Thu-Trang

    2017-01-01

    Objectives General health examinations (GHE) have become an increasingly common measure for preventive medicine in Vietnam. However, little is known about the factors among Viet-namese people who attend or miss GHE. Budget or time constraints remain to be evaluated for better-informed policy making. This study investigates factors affecting behaviors in attending periodic GHE. The main objectives are as follows: (1) to explore empirical relationships between influencing factors and periodic GHE frequencies, and (2) to predict the probabilities of attending GHE under associated conditions. Methods The study used a 2,068-observational dataset, obtained from a Vietnamese survey in 2016. The analysis was then performed using the methods of baseline-category logits for establishing relationships between predictor and response variables. Results Significant relationships were found among the expenditure and time consumption, health priority and sensitivity to health data, insurance status, and frequency of GHE, with most p-values = 0.01. Conclusion Generally, people attended the GHE when they had the resources and health priorities (72.7% probability). Expenditure and time remain key obstacles to the periodic GHE. Health priority and health data are important in improving rates for GHEs. Health insurance should play a positive role in promoting the GHE. PMID:28540159

  4. A Case Study of Behaviour and Performance of Confined or Pastured Cows During the Dry Period

    PubMed Central

    Black, Randi A.; Krawczel, Peter D.

    2016-01-01

    Simple Summary Pasture and freestall systems offer benefits and consequences during lactation but have not been investigated during the dry period. The effect of pasture or confined systems during the dry period on behaviour and milk quality was investigated. Freestall housing resulted in more resting behaviour and less locomotor activity during the dry period compared to pastured cows. At calving, freestall housed cows performed fewer lying bouts and less locomotor activity compared to pastured cows. Pasture resulted in less aggression around feeding but high respiration rates during peak heat times. Pasture during the dry period altered lying behavior, reduced feed bunk aggression and increased heat stress behaviors. Abstract The objectives of this study were to determine the effect of the dry cow management system (pasture or confined) on: (1) lying behaviour and activity; (2) feeding and heat stress behaviours; (3) intramammary infections, postpartum. Non-lactating Holstein cows were assigned to either deep-bedded, sand freestalls (n = 14) or pasture (n = 14) using rolling enrollment. At dry-off, cows were equipped with an accelerometer to determine daily lying time (h/d), lying bouts (bouts/d), steps (steps/d) and divided into periods: far-off (60 to 15 d prepartum), close-up (14 to 1 d prepartum), calving (calving date) and postpartum (1 to 14 d postpartum). Respiration rates were recorded once weekly from dry off to calving from 1300 to 1500 h. Feeding displacements were defined as one cow successfully displacing another from the feed bunk and were recorded once per week during the 2 h period, immediately after feeding at 800 h. Pastured cows were fed a commercial dry cow pellet during far-off and total mixed ration during close-up, with free access to hay and grazing. Freestall housed cows were fed a total mixed ration at far-off and close-up. Cows housed in freestalls were moved to a maternity pen with a mattress at commencement of labour. Pastured cows

  5. Spectroscopic studies of wood fossils from the Crato Formation, Cretaceous Period.

    PubMed

    da Silva, J H; Freire, P T C; Abagaro, B T O; Silva, J A F; Saraiva, G D; de Lima, F J; Barros, O A; Bantim, R A; Saraiva, A A F; Viana, B C

    2013-11-01

    In this work we study two types of wood fossils (Gymnosperms, Araucariaceae) from the Crato Formation of Araripe Basin in Brazil, from the Cretaceous Period. The samples were characterized by Raman and infrared spectroscopies, X-ray diffraction and scanning electron microscopy. The results obtained by different techniques showed that although the rocks surrounding the fossils have predominantly the same constitution - calcite - however, the formation processes of these types of wood fossils are quite different. One of the fossils, denominated as light wood, is predominantly composed of gypsum, while the other fossil, the dark wood, is rich in amorphous carbon, possibly the kerogen type. Implications relative to the environment where the plants lived millions years ago are also given. Finally, the results highlight the constitution of one of the most important paleontological sites of the Cretaceous Period in the South America. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. Studies of phase return map and symbolic dynamics in a periodically driven Hodgkin—Huxley neuron

    NASA Astrophysics Data System (ADS)

    Ding, Jiong; Zhang, Hong; Tong, Qin-Ye; Chen, Zhuo

    2014-02-01

    How neuronal spike trains encode external information is a hot topic in neurodynamics studies. In this paper, we investigate the dynamical states of the Hodgkin—Huxley neuron under periodic forcing. Depending on the parameters of the stimulus, the neuron exhibits periodic, quasiperiodic and chaotic spike trains. In order to analyze these spike trains quantitatively, we use the phase return map to describe the dynamical behavior on a one-dimensional (1D) map. According to the monotonicity or discontinuous point of the 1D map, the spike trains are transformed into symbolic sequences by implementing a coarse-grained algorithm — symbolic dynamics. Based on the ordering rules of symbolic dynamics, the parameters of the external stimulus can be measured in high resolution with finite length symbolic sequences. A reasonable explanation for why the nervous system can discriminate or cognize the small change of the external signals in a short time is also presented.

  7. Dissipative particle dynamics study of phase separation in binary fluid mixtures in periodic and confined domains.

    PubMed

    Gidituri, Harinadha; Anand, D Vijay; Vedantam, Srikanth; Panchagnula, Mahesh V

    2017-08-21

    We investigate the phase separation behavior of binary mixtures in two-dimensional periodic and confined domains using dissipative particle dynamics. Two canonical problems of fluid mechanics are considered for the confined domains: square cavity with no-slip walls and lid-driven cavity with one driven wall. The dynamics is studied for both weakly and strongly separating mixtures and different area fractions. The phase separation process is analyzed using the structure factor and the total interface length. The dynamics of phase separation in the square cavity and lid-driven cavity are observed to be significantly slower when compared to the dynamics in the periodic domain. The presence of the no-slip walls and the inertial effects significantly influences the separation dynamics. Finally, we show that the growth exponent for the strongly separating case is invariant to changes in the inter-species repulsion parameter.

  8. Experimental study of effect of stenosis geometry on pressure loss for periodic flow

    NASA Astrophysics Data System (ADS)

    Veselý, Ondřej; Nováková, Ludmila; Adamec, Josef

    2016-03-01

    A stenosis is a narrowing in a tubular organ. In medicine, vessel stenosis poses health risk for people. In the last work, experimental investigation of pressure loss coefficient for varying stenosis eccentricity and shape for steady flow were performed. In this work, experimental investigation of pressure loss for varying stenosis eccentricity and shape under periodic flow were performed. Four models of different geometry were studied, two models are axisymmetric stenoses and two models are eccentric stenoses. All models were stenosis of 75% area reduction. The periodic flow, generated by a controllable pump, has sinus shape in an inlet. The measuring range of medium Reynolds number was from 500 to 1500, range of ratio between an amplitude and medium flow rate was from 0.2 to 0.6 and range of frequency was from 0.2 to 1 Hz. The pressure loss for each conditions was quantified by mean value, amplitude and phase shift against flow rate.

  9. Dissipative particle dynamics study of phase separation in binary fluid mixtures in periodic and confined domains

    NASA Astrophysics Data System (ADS)

    Gidituri, Harinadha; Anand, D. Vijay; Vedantam, Srikanth; Panchagnula, Mahesh V.

    2017-08-01

    We investigate the phase separation behavior of binary mixtures in two-dimensional periodic and confined domains using dissipative particle dynamics. Two canonical problems of fluid mechanics are considered for the confined domains: square cavity with no-slip walls and lid-driven cavity with one driven wall. The dynamics is studied for both weakly and strongly separating mixtures and different area fractions. The phase separation process is analyzed using the structure factor and the total interface length. The dynamics of phase separation in the square cavity and lid-driven cavity are observed to be significantly slower when compared to the dynamics in the periodic domain. The presence of the no-slip walls and the inertial effects significantly influences the separation dynamics. Finally, we show that the growth exponent for the strongly separating case is invariant to changes in the inter-species repulsion parameter.

  10. Studies of short-period comets on the eve of Rosetta

    NASA Astrophysics Data System (ADS)

    Pozuelos, F. J.; Moreno, F.; Aceituno, F.; Casanova, V.; Sota, A.; López-Moreno, J. J.; Cometas-Obs Team

    2015-05-01

    We present an extended study of the dust environment of a sample of short-period comets and their dynamical history. With this aim, we characterized the dust tails when the comets are active, and we make a statistical study to determine their dynamical evolution. The targets selected were 22P/Kopff, 30P/Reinmuth 1, 78P/Gehrels 2, 81P/Wild 2, 103P/Hartley 2, 115P/Maury, 118P/Shoemaker-Levy 4, 123P/West-Hartley, 157P/Tritton, 185P/Petriew, P/2011 W2 (Rinner).

  11. 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.

  12. Clinical management of dying patients.

    PubMed Central

    Gavrin, J; Chapman, C R

    1995-01-01

    Dying is universal, and death should be a peaceful time. Myriad comfort measures are available in the last weeks before life ends. Discussions about end-of-life issues often suffer from lack of informed opinion. Palliative care experts have identified specific somatic and psychological sources of distress for dying patients and their loved ones. Pain, shortness of breath, nausea and vomiting, and fear of abandonment contribute substantially to both physical and psychological discomfort toward the end of life. Simple, effective methods exist for relieving those symptoms. Knowledge about the natural events associated with dying and an informed approach to medical and psychological interventions contribute to systematic and successful comfort care. We describe the origin of physical and psychological distress at the end of life and provide strategies for alleviating many of the discomforts. PMID:7571591

  13. Critical periods after stroke study: translating animal stroke recovery experiments into a clinical trial

    PubMed Central

    Dromerick, Alexander W.; Edwardson, Matthew A.; Edwards, Dorothy F.; Giannetti, Margot L.; Barth, Jessica; Brady, Kathaleen P.; Chan, Evan; Tan, Ming T.; Tamboli, Irfan; Chia, Ruth; Orquiza, Michael; Padilla, Robert M.; Cheema, Amrita K.; Mapstone, Mark E.; Fiandaca, Massimo S.; Federoff, Howard J.; Newport, Elissa L.

    2015-01-01

    Introduction: Seven hundred ninety-five thousand Americans will have a stroke this year, and half will have a chronic hemiparesis. Substantial animal literature suggests that the mammalian brain has much potential to recover from acute injury using mechanisms of neuroplasticity, and that these mechanisms can be accessed using training paradigms and neurotransmitter manipulation. However, most of these findings have not been tested or confirmed in the rehabilitation setting, in large part because of the challenges in translating a conceptually straightforward laboratory experiment into a meaningful and rigorous clinical trial in humans. Through presentation of methods for a Phase II trial, we discuss these issues and describe our approach. Methods: In rodents there is compelling evidence for timing effects in rehabilitation; motor training delivered at certain times after stroke may be more effective than the same training delivered earlier or later, suggesting that there is a critical or sensitive period for strongest rehabilitation training effects. If analogous critical/sensitive periods can be identified after human stroke, then existing clinical resources can be better utilized to promote recovery. The Critical Periods after Stroke Study (CPASS) is a phase II randomized, controlled trial designed to explore whether such a sensitive period exists. We will randomize 64 persons to receive an additional 20 h of upper extremity therapy either immediately upon rehab admission, 2–3 months after stroke onset, 6 months after onset, or to an observation-only control group. The primary outcome measure will be the Action Research Arm Test (ARAT) at 1 year. Blood will be drawn at up to 3 time points for later biomarker studies. Conclusion: CPASS is an example of the translation of rodent motor recovery experiments into the clinical setting; data obtained from this single site randomized controlled trial will be used to finalize the design of a Phase III trial. PMID

  14. Joint HVDC Agricultural Study : Annual Progress Report for the 1985 Study Period.

    SciTech Connect

    Raleigh, Robert J.

    1986-02-01

    This report describes the first year of a 3-year study designed to assess the possible environmental effects of a +-500-kV dc transmission line. This first annual report documents site development, initiation of the livestock and crop studies, and the integration and interfacing of the agricultural and BPA's electrical monitoring study. The overall objective is to assess whether operation of a +-500-kV dc transmission line results in any detectable effects (beneficial or adverse) on plants or livestock, under controlled, simulated farming and ranching conditions. These two biological systems were selected because they can be expected to experience long-term exposure to maximum field and ion concentrations on the transmission right-of-way. This study is designed to provide data on end points and parameters of primary interest in commercial farming and ranching operations.

  15. 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.

  16. Die Herz-Lungen-Maschine

    NASA Astrophysics Data System (ADS)

    Krane, Markus; Bauernschmitt, Robert; Lange, Rüdiger

    Das Kapitel der modernen Herzchirurgie mit Einsatz der Herz-Lungen-Maschine am Menschen beginnt am 6. Mai 1953, als J. Gibbon bei einer 18-jährigen Patientin einen angeborenen Defekt in der Vorhofscheidewand verschließt [1]. Mit ersten experimentellen Versuchen zur extrakorporalen Zirkulation begann Gibbon bereits in den 30er Jahren des 20. Jahrhunderts. Die Grundlage für die heute gebräuchliche Rollerpumpe schufen Porter und Bradley mit ihrer "rotary pump“, welche sie 1855 zum Patent anmeldeten. Diese Pumpe wurde von DeBakey und Schmidt modifiziert und entspricht im Wesentlichen noch der heute sich im Routinebetrieb befindlichen Rollerpumpe [2].

  17. Misconceptions Die Hard.

    ERIC Educational Resources Information Center

    Stepans, Joseph I.; And Others

    1986-01-01

    Discusses a study of students' conceptualizations and misconceptions of how objects sink and float. Results showed little difference in the levels of understanding of the "sink and float" concepts by groups ranging from primary age to college. As age increased, terminology used by students varied, and misuse of terms increased. (TW)

  18. Is Head Start Dying?

    ERIC Educational Resources Information Center

    Sherman, Ann; And Others

    1971-01-01

    Analysis of problems faced by Head Start and its present status includes a review of its transfer from O.E.O. to H.E.W., its extensions, the Westinghouse Report, and other studies and articles. Decline in public interest and support is noted. (KW)

  19. Dying for a Drink.

    ERIC Educational Resources Information Center

    Black, Susan

    2003-01-01

    Studies show that 40 percent of youth who begin drinking before age 13 are classified as alcohol dependent at some point in their lives. Explores three theories about adolescents' alcohol use, describes a national intervention program, lists warning signs of early drinking, and offers a policy preventing early drinking. (MLF)

  20. Misconceptions Die Hard.

    ERIC Educational Resources Information Center

    Stepans, Joseph I.; And Others

    1986-01-01

    Discusses a study of students' conceptualizations and misconceptions of how objects sink and float. Results showed little difference in the levels of understanding of the "sink and float" concepts by groups ranging from primary age to college. As age increased, terminology used by students varied, and misuse of terms increased. (TW)

  1. Is Business Ethics Dying?

    ERIC Educational Resources Information Center

    Pamental, George L.

    1991-01-01

    Discusses the need for business ethics courses in undergraduate and graduate business degree programs. Describes reasons for and objections to such programs. Explains that business ethics instruction requires varied case studies, adequate teaching materials, cooperation between philosophers and business faculty, and instructors who are forthcoming…

  2. Dying for a Drink.

    ERIC Educational Resources Information Center

    Black, Susan

    2003-01-01

    Studies show that 40 percent of youth who begin drinking before age 13 are classified as alcohol dependent at some point in their lives. Explores three theories about adolescents' alcohol use, describes a national intervention program, lists warning signs of early drinking, and offers a policy preventing early drinking. (MLF)

  3. On Flowfield Periodicity in the NASA Transonic Flutter Cascade. Part 2; Numerical Study

    NASA Technical Reports Server (NTRS)

    Chima, Rodrick V.; McFarland, Eric R.; Wood, Jerry R.; Lepicovsky, Jan

    2000-01-01

    The transonic flutter cascade facility at NASA Glenn Research Center was redesigned based on a combined program of experimental measurements and numerical analyses. The objectives of the redesign were to improve the periodicity of the cascade in steady operation, and to better quantify the inlet and exit flow conditions needed for CFD predictions. Part I of this paper describes the experimental measurements, which included static pressure measurements on the blade and endwalls made using both static taps and pressure sensitive paints, cobra probe measurements of the endwall boundary layers and blade wakes, and shadowgraphs of the wave structure. Part II of this paper describes three CFD codes used to analyze the facility, including a multibody panel code, a quasi-three-dimensional viscous code, and a fully three-dimensional viscous code. The measurements and analyses both showed that the operation of the cascade was heavily dependent on the configuration of the sidewalls. Four configurations of the sidewalls were studied and the results are described. For the final configuration, the quasi-three-dimensional viscous code was used to predict the location of mid-passage streamlines for a perfectly periodic cascade. By arranging the tunnel sidewalls to approximate these streamlines, sidewall interference was minimized and excellent periodicity was obtained.

  4. Applying Data-mining techniques to study drought periods in Spain

    NASA Astrophysics Data System (ADS)

    Belda, F.; Penades, M. C.

    2010-09-01

    Data-mining is a technique that it can be used to interact with large databases and to help in the discovery relations between parameters by extracting information from massive and multiple data archives. Drought affects many economic and social sectors, from agricultural to transportation, going through urban water deficit and the development of modern industries. With these problems and drought geographical and temporal distribution it's difficult to find a single definition of drought. Improving the understanding of the knowledge of climatic index is necessary to reduce the impacts of drought and to facilitate quick decisions regarding this problem. The main objective is to analyze drought periods from 1950 to 2009 in Spain. We use several kinds of information, different formats, sources and transmission mode. We use satellite-based Vegetation Index, dryness index for several temporal periods. We use daily and monthly precipitation and temperature data and soil moisture data from numerical weather model. We calculate mainly Standardized Precipitation Index (SPI) that it has been used amply in the bibliography. We use OLAP-Mining techniques to discovery of association rules between remote-sensing, numerical weather model and climatic index. Time series Data- Mining techniques organize data as a sequence of events, with each event having a time of recurrence, to cluster the data into groups of records or cluster with similar characteristics. Prior climatological classification is necessary if we want to study drought periods over all Spain.

  5. Do accidents happen accidentally? A study of trauma registry and periodical examination database.

    PubMed

    Avi, A; Yehonatan, S; Alon, S; Alexandra, H; Arieh, E

    2001-01-01

    Health profile of trauma victims might affect accident involvement. Information linking medical data to accident epidemiology is lacking. This study aims to identify health factors that increase risk of accident involvement. The Israeli Defense Forces maintains two databases: records of periodical health examination of military personnel and a trauma registry including emergency department referrals of personnel resulting from injury. We identified 5,578 subjects who were examined in the Periodical Health Examination Center and were victims of trauma. We analyzed relation between injuries and various health parameters. Results shows cigarette smoking is more frequent among the population involved in trauma (40% in motor vehicle crash, 37% in fall injury, and 31% in blunt contusion compared with 28% in Periodical Health Examination Center population not involved in trauma, p < 0.05). Odds ratio of smokers involvement in motor vehicle crash is 1.82 (95% confidence interval, 1.25-2.67, p < 0.005). Younger age is relatively more frequent among trauma victims. We conclude that cigarette smokers and younger subjects might be at greater risk of being involved in accidental injuries.

  6. Photometric study of the contact binary 07g-3-00820 at the period cut off

    NASA Astrophysics Data System (ADS)

    Gao, H.-Y.; Li, K.; Li, Q.-C.; Ma, S.

    2017-10-01

    07g-3-00820 is a K-type contact binary system with a period of 0.2269551 days. This extremely short period makes this system a rare target whose period is close to the empirical limit (0.22 days). Rc and Ic light curves of this binary were obtained using the 1.0 m reflecting telescope at Weihai Observatory of Shandong University. A high mass ratio of q = 1.300 ± 0.006 and a low contact degree of f = 5 % ± 1.5 % were determined from a photometric study using the Wilson-Devinney method. The following parameters of this W-subtype shallow contact system were derived: M1 = 0.621 ± 0.072M⊙ , M2 = 0.807 ± 0.093M⊙ , R1 = 0.634 ± 0.036R⊙ , R2 = 0.710 ± 0.037R⊙ , L1 = 0.270 ± 0.037L⊙ , and L2 = 0.339 ± 0.048L⊙ . By analyzing the location of the two components on the mass-luminosity diagram, we provide a preliminary discussion on the properties and the state of evolution of this system.

  7. Short communication: study of immune parameters in three Greek dairy sheep breeds during the periparturient period.

    PubMed

    Theodorou, G; Fragou, S; Chronopoulou, R; Kominakis, A; Rogdakis, E; Politis, I

    2007-12-01

    The objective of the present study was to evaluate whether immunosuppression occurs in 3 different Greek dairy sheep breeds during the periparturient period. A total of 33 ewes from 3 breeds [i.e., the low-producing Boutsiko breed (n = 11), which is highly adaptable to harsh environments; the high-producing but environmentally fragile Chios breed (n = 11); and an intermediate synthetic breed (50% Boutsiko, 25% Arta, and 25% Chios, n = 11)] were used. Blood samples were collected at 18 and 2 d before parturition and at 15 d after parturition. Total cell-associated and membrane-bound urokinase plasminogen activator (U-PA) activity, free U-PA binding sites on cellular membranes, and superoxide anion (SA) production by activated phagocytes were determined. Results indicated that all immune parameters measured remained constant during the periparturient period for the Boutsiko breed. In contrast, there were reductions in total cell-associated and membrane-bound U-PA activity by both monocytes-macrophages and neutrophils and in SA production by monocytes-macrophages at d 2 before parturition for the Chios breed. In the synthetic breed, there were reductions in total cell-associated and membrane-bound U-PA activity by monocytes-macrophages and in SA production by both monocytes-macrophages and neutrophils at d 15 after parturition. Thus, mild immunosuppression during the periparturient period was observed in the 2 breeds with the highest milk production.

  8. A comparative study of stress episode prevalence and duration among Jomon period foragers from Hokkaido.

    PubMed

    Temple, Daniel H; McGroarty, Jennifer N; Guatelli-Steinberg, Debbie; Nakatsukasa, Masato; Matsumura, Hirofumi

    2013-10-01

    This study reconstructs linear enamel hypoplasia (LEH) prevalence and stress episode duration among Jomon period foragers from Hokkaido, Japan (HKJ). Results are compared to Jomon period samples from coastal Honshu, Japan (HSJ) and Tigara Inupiat from Point Hope, Alaska (PHT) to provide a more comprehensive perspective on the manifestation of stress among circum-Pacific foragers. LEH were identified macro- and microscopically by enamel surface depressions and increased perikymata spacing within defects. Individuals with more than one anterior tooth affected by LEH were labeled as LEH positive. Stress episode durations were estimated by counting the number of perikymata within the occlusal wall of each LEH and multiplying that number by constants reflecting modal periodicities for modern human teeth. LEH prevalence and stress episode duration did not differ significantly between the two Jomon samples. Significantly greater frequencies of LEH were found in HKJ as compared to PHT foragers. However, HKJ foragers had significantly shorter stress episode durations as compared to PHT. This suggests that a greater proportion of HKJ individuals experienced stress episodes than did PHT individuals, but these stress events ended sooner. Similarity in stress experiences between the two Jomon samples and differences between the HKJ and PHT are found. These findings are important for two reasons. First, stress experiences of foraging populations differ markedly and cannot be generalized by subsistence strategy alone. Second, due to significant differences in episode duration, stress experiences cannot be understood using prevalence comparisons alone.

  9. Long-term oncologic outcomes of laparoscopic right hemicolectomy during the learning curve period: comparative study with cases after the learning curve period.

    PubMed

    Park, Eun Jung; Kim, Min Sung; Kim, Gangmi; Kim, Chang Hee; Hur, Hyuk; Min, Byung So; Baik, Seung Hyuk; Lee, Kang Young; Kim, Nam Kyu

    2015-02-01

    This study aimed to assess the learning curve in laparoscopic right hemicolectomy and compare the long-term oncologic outcomes of the learning curve period. We retrospectively reviewed 97 patients who underwent a laparoscopic right hemicolectomy by a single surgeon between July 2006 and January 2009. Among them, 87 patients, excluding patients with stage IV (n=10) disease, were evaluated for long-term oncologic outcomes. They were divided into 2 phases: phase 1 (the learning curve period) and phase 2 (the expert period). The cumulative sum method was used for estimating the learning curve. The learning curve was determined at the 42nd case. Patient characteristics and postoperative clinicopathologic outcomes were similar in both groups except for the operation time (212.5±65.0 min vs. 146.4±37.1 min; P<0.001) and length of stay (10.7±5.4 d vs. 8.4±2.9 d; P=0.015). The 5-year overall survival rates were similar in both groups throughout all stages. The 5-year disease-free survival rate of stage III disease in phase 2 (85%) was better than that of phase 1 (53.3%; P=0.046). Laparoscopic right hemicolectomy during the learning curve period showed acceptable clinicopathologic outcomes. However, the 5-year disease-free survival rate was compromised in patients with stage III disease in phase I.

  10. '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.

  11. Should age-period-cohort studies return to the methodologies of the 1970s?

    PubMed

    Reither, Eric N; Masters, Ryan K; Yang, Yang Claire; Powers, Daniel A; Zheng, Hui; Land, Kenneth C

    2015-03-01

    Social scientists have recognized the importance of age-period-cohort (APC) models for half a century, but have spent much of this time mired in debates about the feasibility of APC methods. Recently, a new class of APC methods based on modern statistical knowledge has emerged, offering potential solutions. In 2009, Reither, Hauser and Yang used one of these new methods - hierarchical APC (HAPC) modeling - to study how birth cohorts may have contributed to the U.S. obesity epidemic. They found that recent birth cohorts experience higher odds of obesity than their predecessors, but that ubiquitous period-based changes are primarily responsible for the rising prevalence of obesity. Although these findings have been replicated elsewhere, recent commentaries by Bell and Jones call them into question - along with the new class of APC methods. Specifically, Bell and Jones claim that new APC methods do not adequately address model identification and suggest that "solid theory" is often sufficient to remove one of the three temporal dimensions from empirical consideration. They also present a series of simulation models that purportedly show how the HAPC models estimated by Reither et al. (2009) could have produced misleading results. However, these simulation models rest on assumptions that there were no period effects, and associations between period and cohort variables and the outcome were perfectly linear. Those are conditions under which APC models should never be used. Under more tenable assumptions, our own simulations show that HAPC methods perform well, both in recovering the main findings presented by Reither et al. (2009) and the results reported by Bell and Jones. We also respond to critiques about model identification and theoretically-imposed constraints, finding little pragmatic support for such arguments. We conclude by encouraging social scientists to move beyond the debates of the 1970s and toward a deeper appreciation for modern APC methodologies

  12. Should Age-Period-Cohort Studies Return to the Methodologies of the 1970s?

    PubMed Central

    Masters, Ryan K.; Yang, Y. Claire; Powers, Daniel A.; Zheng, Hui; Land, Kenneth C.

    2015-01-01

    Social scientists have recognized the importance of age-period-cohort (APC) models for half a century, but have spent much of this time mired in debates about the feasibility of APC methods. Recently, a new class of APC methods based on modern statistical knowledge has emerged, offering potential solutions. In 2009, Reither, Hauser and Yang used one of these new methods – hierarchical APC (HAPC) modeling – to study how birth cohorts may have contributed to the U.S. obesity epidemic. They found that recent birth cohorts experience higher odds of obesity than their predecessors, but that ubiquitous period-based changes are primarily responsible for the rising prevalence of obesity. Although these findings have been replicated elsewhere, recent commentaries by Bell and Jones call them into question – along with the new class of APC methods. Specifically, Bell and Jones claim that new APC methods do not adequately address model identification and suggest that “solid theory” is often sufficient to remove one of the three temporal dimensions from empirical consideration. They also present a series of simulation models that purportedly show how the HAPC models estimated by Reither et al. (2009) could have produced misleading results. However, these simulation models rest on assumptions that there were no period effects, and associations between period and cohort variables and the outcome were perfectly linear. Those are conditions under which APC models should never be used. Under more tenable assumptions, our own simulations show that HAPC methods perform well, both in recovering the main findings presented by Reither et al. (2009) and the results reported by Bell and Jones. We also respond to critiques about model identification and theoretically-imposed constraints, finding little pragmatic support for such arguments. We conclude by encouraging social scientists to move beyond the debates of the 1970s and toward a deeper appreciation for modern APC

  13. Plasma adiponectin and depressive symptoms during pregnancy and the postpartum period: A prospective cohort study.

    PubMed

    Rebelo, Fernanda; Farias, Dayana R; Struchiner, Claudio J; Kac, Gilberto

    2016-04-01

    Some authors have described an inverse association between adiponectin and depression, but this association has not yet been investigated during the perinatal period. To evaluate the association between the plasma adiponectin levels and symptoms of depression in women from early pregnancy to 30-45 days postpartum. A prospective cohort of 235 women was analyzed, with four waves of follow-up: 5-13th, 22-26th, and 30-36th gestational weeks and 30-45 days postpartum. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS; cutoff ≥ 11). The plasma adiponectin concentrations were measured using an enzyme-linked immunosorbent assay. The statistical analyses included linear mixed effects regressions to model the association between these time-dependent variables. The prevalence of depressive symptoms was 35.5%, 22.8%, 21.8%, and 16.9% and the median (µg/mL) adiponectin levels were 4.8, 4.7, 4.4, and 7.5 in the 1st, 2nd, and 3rd trimesters and the postpartum period, respectively. Women who remained non-depressed throughout the study tended to have higher values of adiponectin throughout pregnancy and the postpartum period compared to those who had depressive symptoms at least once, but this difference was not statistically significant (β=-0.14; p=0.071). There was no statistically significant association between the plasma adiponectin levels and the EPDS scores in the multiple model (β=-0.07; p=0.320). Losses to follow-up, different procedures for the blood draws at the prenatal and postpartum visits, and the presence of a nested clinical trial with omega-3 supplementation. The plasma adiponectin levels were not associated with depressive symptoms during the perinatal period. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. A bibliometric study of international scientific productivity in giardiasis covering the period 1971-2010.

    PubMed

    Escobedo, Angel A; Arencibia, Ricardo; Vega, Rosa L; Rodríguez-Morales, Alfonso J; Almirall, Pedro; Alfonso, Maydel

    2015-01-15

    Despite years of relative neglect, interest in Giardia infection seems to be recently growing, perhaps in part due to its inclusion into the World Health Organization's Neglected Diseases Initiative since 2004. The purpose of this study was to provide an overview of Giardia and giardiasis research over time, as represented by the quantity of published papers. Data for this study were collected from the electronic PubMed/Medline database of National Library of Medicine's (NLM), due to it is easily accessibility and wide use. It was accessed online between April and December 2011. Data for the period 1971-2010 were obtained and information was downloaded using the EndNote program developed by Thomson Reuters. During the study period, a total of 6,964 references (articles, reviews, editorials, letter to the editor, etc.) covering different aspects of Giardia and giardiasis were located in the PubMed database after applying the search strategy reported above. Most papers were original articles and published in English. In this first effort to explore the development and research productivity on giardiasis over time (no previously published bibliometric studies on giardiasis exist), two interesting characteristics of the Giardia and giardiasis literature were discovered: the concentration of papers over journals disseminating the research results, and that research in this field is growing and will likely continue to grow in the coming years.

  15. The depression in women in pregnancy and postpartum period: A follow-up study.

    PubMed

    Kirkan, Tulay Sati; Aydin, Nazan; Yazici, Esra; Aslan, Puren Akcali; Acemoglu, Hamit; Daloglu, Ali Gokhan

    2015-06-01

    This was a follow-up study to determine postpartum depression (PPD) and its causes in a population previously evaluated in the first trimester of pregnancy. The study sample consisted of pregnant women who were evaluated in the first trimester and 360 women who were re-evaluated in the postpartum period. Detailed sociodemographic data were obtained from the women, and depression was assessed with the Edinburgh Postpartum Depression scale (EPDS) and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM) Axis I Disorders (SCID-I). In this follow-up study, the prevalence of PPD was 35% (n = 126). A depressive disorder in the first trimester of pregnancy, previous mental disorder, somatic disorder, exposure to domestic violence during pregnancy, baby's staying in the incubator and not breastfeeding were predictors of PPD. Exposure to violence and a history of previous depression predicted depression both in pregnancy and in the postpartum period. Depression rates are high in Eastern Turkey. Exposure to violence during pregnancy and the existence of a previous mental disorder were risk factors for perinatal depression in this study. Performing screening tests can identify women at risk of pregnancy-related depression. Prevention programs should be established in areas where the prevalence of depression is high. © The Author(s) 2014.

  16. The dying animal.

    PubMed

    Pierce, Jessica

    2013-12-01

    The study of animal death is poised to blossom into an exciting new interdisciplinary field-and one with profound relevance for bioethics. Areas of interest include the biology and evolution of death-related behavior in nonhuman animals, as well as human social, psychological, cultural, and moral attitudes toward and practices related to animal death. In this paper, I offer a brief overview of what we know about death-related behavior in animals. I will then sketch some of the bioethical implications of this emerging field of research.

  17. Study of corrosion using long period fiber gratings coated with iron exposed to salty water

    NASA Astrophysics Data System (ADS)

    Coelho, L.; Santos, J. L.; Jorge, P. A. S.; de Almeida, J. M. M.

    2017-04-01

    A study of long period fiber gratings (LPFG) over coated with iron (Fe) and subjected to oxidation in water with different sodium chloride (NaCl) concentrations is presented. The formation of iron oxides and hydroxides was monitored in real time by following the features of the LPFG attenuation band. Preliminary results show that Fe coated LPFGs can be used as sensors for early warning of corrosion in offshore and in coastal projects where metal structures made of iron alloys are in contact with sea or brackish water.

  18. Theoretical study on interfacial impact ionization in AlN/GaN periodically stacked structure

    NASA Astrophysics Data System (ADS)

    Zheng, Jiyuan; Wang, Lai; Wu, Xingzhao; Hao, Zhibiao; Sun, Changzheng; Xiong, Bing; Luo, Yi; Han, Yanjun; Wang, Jian; Li, Hongtao; Li, Mo; Kang, Jianbin; Li, Qian

    2017-07-01

    A theoretical study on interfacial ionization in the AlN/GaN periodically stacked structure (PSS) avalanche photodiode (APD) has been carried out to explain why the experimental electron ionization coefficient is higher than that in the simulation result. Full band structures for GaN and AlN are combined at the heterojunction interface of the PSS APD for the calculation of the suitable initial ionization state in AlN. Many suitable initial states exist in the Γ valley of AlN, where scattering rates are restricted and ultimately result in a higher ionization coefficient.

  19. Physicians' views of periodic abstinence methods: a study in four countries.

    PubMed

    Snowden, R; Kennedy, K I; Leon, F; Orense, V C; Perera, H W; Phillips, R; Askew, I; Flynn, A; Severy, L J

    1988-01-01

    A study of the knowledge, perceptions, and behavioral intentions of physicians regarding periodic abstinence (PA) methods was undertaken in Mauritius, Peru, the Philippines, and Sri Lanka. Most respondents considered PA to be useful, although even the PA providers prescribed mainly non-PA methods. Detailed knowledge of PA methods was not evident, but most physicians were willing to initiate general discussion about PA with patients. Physicians favored methods perceived as "scientific" and "modern," which primarily prevent pregnancy and secondarily avoid other health risks. When carefully presented as "scientific" and "modern," methods presented to medical audiences may find acceptance and be more likely to result in referral.

  20. A Mathematical Study of a TB Model with Treatment Interruptions and Two Latent Periods

    PubMed Central

    Liu, Luju; Wang, Yan

    2014-01-01

    A TB transmission model which incorporates treatment interruptions and two latent periods is presented. The threshold parameter known as the control reproduction number and the equilibria for the model are determined, and the global asymptotical stabilities of the equilibria are studied by constructing the proper Lyapunov functions. The reproduction numbers and numerical simulations show that treatment of active TB cases always helps to control the TB epidemic, while treatment interruptions may have a negative, positive, or no effect on combating TB epidemic. PMID:24963343

  1. DMFT Study for Valence Fluctuations in the Extended Periodic Anderson Model

    NASA Astrophysics Data System (ADS)

    Shinzaki, Ryu; Nasu, Joji; Koga, Akihisa

    2016-02-01

    We study valence fluctuations at finite temperatures in the extended periodic Anderson model, where the Coulomb interaction between conduction and localized f-electrons is taken into account, using dynamical mean-field theory combined with the continuous-time quantum Monte Carlo (CT-QMC) method. The valence transition with the hysteresis is clearly found, indicating the first-order phase transition between the Kondo and mixed-valence states. We demonstrate that spin correlation rapidly develops when the system approaches the valence transition point. The comparison of the impurity solvers, the CT-QMC, non-crossing approximation, and one-crossing approximation, is also addressed.

  2. [Death and dying process: evidences from the literature of nursing].

    PubMed

    Júnior, Fernando José Guedes da Silva; Santos, Lissandra Chaves de Sousa; Moura, Pedro Victor dos Santos; Melo, Belisa Maria Silva; Monteiro, Claudete Ferreira de Souza

    2011-01-01

    The objective was to identify the profile of production and analyze perceptions, feelings and confrontations on the process of death and dying in the practice evidenced in nursing scientific production in the period 1994 to 2009. There was a qualitative, descriptive research, developed through a systematic literature review with metasynthesis from the meta-ethnographic method. Ten studies met the inclusion criteria, this set was subjected to quality assessment checklist with Critical Appraisal Skills Programme. Subjects perceive this process as a transition, separation and finitude. This is permeated with feelings of frustration and powerlessness and the most effective interventions to this issue is the development of coping strategies that vary with the reality of each individual.

  3. Validation studies of the Edinburgh Postnatal Depression Scale for the antenatal period.

    PubMed

    Kozinszky, Zoltan; Dudas, Robert B

    2015-05-01

    Relatively few studies have focused on the validation of psychometric scales measuring depression during pregnancy. The aim of this review was to critically appraise and review antenatal validation studies of the Edinburgh Postnatal Depression Scale (EPDS). A systematic search was performed in MEDLINE, EMBASE, ISI, CINAHL, SCIELO and PsyCINFO for the period 1987-2013. Eleven validation studies met the inclusion criteria. The study design varied between studies. Sensitivity and specificity estimates also varied between 64-100% and 73-100%, respectively. The confidence interval estimates also showed a high degree of variability. Our estimates suggest lower positive predictive values in the general population than those reported in the validation study samples. The sensitivity values in validation studies of the EPDS show fairly large variability, ranging from good to acceptable. Future studies should have larger sample sizes and include both representative and clinical samples and look at the psychometric performance of the EPDS in each trimester. Due to differences in study design and variation in the cultural/linguistic adaptation, uncertainty remains regarding the comparability of the sensitivity and specificity estimates of different EPDS versions. Future studies should have larger sample sizes, include both representative and clinical samples, and look at the psychometric performance of the EPDS in each trimester. Reporting quality, especially as regards checks to ensure content validity, should be improved. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Analytical Study of Periodic Solutions on Perturbed Equatorial Two-Body Problem

    NASA Astrophysics Data System (ADS)

    Abouelmagd, Elbaz I.; Mortari, Daniele; Selim, Hadia H.

    2015-12-01

    This paper presents analytical derivations to study periodic solutions for the two-body problem perturbed by the first zonal harmonic parameter. In particular, three different semianalytical approaches to solve this problem have been studied: (1) the classic perturbation theory, (2) the Lindstedt-Poincaré technique, and (3) the Krylov-Bogoliubov-Mitropolsky method. In addition, the numerical integration by Runge-Kutta algorithm is established. However, the numerical comparison tests show that by increasing the value of angular momentum the solutions provided by Lindstedt-Poincaré and Krylov-Bogoliubov-Mitropolsky methods become similar, and they provide almost identical results using a smaller value for the perturbed parameter which quantify the dynamical flattening of the main body, the Krylov-Bogoliubov-Mitropolsky provides more accurate results to design elliptical periodic solutions than Lindstedt-Poincaré technique when the perturbed parameter has a relatively large value, regardless of the value of angular momentum. This study can be applied to equatorial orbits to obtain closed-form analytical solutions.

  5. Puberty as a Critical Risk Period for Eating Disorders: A Review of Human and Animal Studies

    PubMed Central

    Klump, Kelly L.

    2013-01-01

    Puberty is one of the most frequently discussed risk periods for the development of eating disorders. Prevailing theories propose environmentally mediated sources of risk arising from the psychosocial effects (e.g., increased body dissatisfaction, decreased self-esteem) of pubertal development in girls. However, recent research highlights the potential role of ovarian hormones in phenotypic and genetic risk for eating disorders during puberty. The goal of this paper is to review data from human and animal studies in support of puberty as a critical risk period for eating disorders and evaluate the evidence for hormonal contributions. Data are consistent in suggesting that both pubertal status and pubertal timing significantly impact risk for most eating disorders in girls, such that advanced pubertal development and early pubertal timing are associated with increased rates of eating disorders and their symptoms in both cross-sectional and longitudinal research. Findings in boys have been much less consistent and suggest a smaller role for puberty in risk for eating disorders in boys. Twin and animal studies indicate that at least part of the female-specific risk is due to genetic factors associated with estrogen activation at puberty. In conclusion, data thus far support a role for puberty in risk for eating disorders and highlight the need for additional human and animal studies of hormonal and genetic risk for eating disorders during puberty. PMID:23998681

  6. Puberty as a critical risk period for eating disorders: a review of human and animal studies.

    PubMed

    Klump, Kelly L

    2013-07-01

    This article is part of a Special Issue "Puberty and Adolescence". Puberty is one of the most frequently discussed risk periods for the development of eating disorders. Prevailing theories propose environmentally mediated sources of risk arising from the psychosocial effects (e.g., increased body dissatisfaction, decreased self-esteem) of pubertal development in girls. However, recent research highlights the potential role of ovarian hormones in phenotypic and genetic risk for eating disorders during puberty. The goal of this paper is to review data from human and animal studies in support of puberty as a critical risk period for eating disorders and evaluate the evidence for hormonal contributions. Data are consistent in suggesting that both pubertal status and pubertal timing significantly impact risk for most eating disorders in girls, such that advanced pubertal development and early pubertal timing are associated with increased rates of eating disorders and their symptoms in both cross-sectional and longitudinal research. Findings in boys have been much less consistent and suggest a smaller role for puberty in risk for eating disorders in boys. Twin and animal studies indicate that at least part of the female-specific risk is due to genetic factors associated with estrogen activation at puberty. In conclusion, data thus far support a role for puberty in risk for eating disorders and highlight the need for additional human and animal studies of hormonal and genetic risk for eating disorders during puberty. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Characteristics of patients who die in hospital with no attempt at resuscitation.

    PubMed

    Aune, Solveig; Herlitz, Johan; Bång, Angela

    2005-06-01

    To describe the characteristics, cause of hospitalisation and symptoms prior to death in patients dying in hospital without resuscitation being started and the extent to which these decisions were documented. All patients who died at Sahlgrenska University Hospital in Goteborg, Sweden, in whom cardiopulmonary resuscitation (CPR) was not attempted during a period of one year. Among 674 patients, 71% suffered respiratory insufficiency, 43% were unconscious and 32% had congestive heart failure during the 24h before death. In the vast majority of patients, the diagnosis on admission to hospital was the same as the primary cause of death. The cause of death was life-threatening organ failure, including malignancy (44%), cerebral lesion (10%) and acute coronary syndrome (10%). The prior decision of 'do not attempt resuscitation' (DNAR) was documented in the medical notes in 82%. In the remaining 119 patients (18%), only 16 died unexpectedly. In all these 16 cases, it was regarded retrospectively as ethically justifiable not to start CPR. In patients who died at a Swedish University Hospital, we did not find a single case in which it was regarded as unethical not to start CPR. The patient group studied here had a poor prognosis due to a severe deterioration in their condition. To support this, we also found a high degree of documentation of DNAR. The low rate of CPR attempts after in-hospital cardiac arrest appears to be justified.

  8. Vascular trauma in Western Australia: a comparison of two study periods over 15 years.

    PubMed

    Friend, Jikol; Rao, Sudhakar; Sieunarine, Kishore; Woodroof, Paul

    2016-03-01

    Royal Perth Hospital (RPH) has become Western Australia's only designated adult major trauma facility since a previous study of vascular trauma was conducted in 2001 at the same facility. The aim of this study is to identify changes in vascular trauma patterns over the two study periods and compare these changes with international literature. All individuals presenting to RPH between January 2000 and December 2010 with vascular injury were identified from a prospective trauma database for this descriptive study. Injuries were classified using the Abbreviated Injury Score (AIS). The incidence of vascular trauma as a percentage of total trauma increased over the two study periods. The current 10-year study included 45 164 patients on the trauma database, of which 1205 patients (2.6%) sustained 1335 vascular injuries, an increase from 1% in the previous 5-year study at the same facility. Males aged 20-29 years were more frequently injured. Blunt trauma occurred more frequently than penetrating. The extremities, particularly the upper limbs were most commonly injured. The most common causes of injury for each region were as follows; motorbike crash (MBC), motor vehicle crash (MVC) and stabbing (neck, thorax and abdomen), MBC and MVC (lower limb) and piercing injuries (upper limb). Injury Severity Score (ISS) and mortality 43% (32 of 75) were highest for thoracic injuries, particularly thoracic aorta injury. Mortality rate has decreased. Vascular injuries in Western Australia are increasing. MVC are the most common cause of life threatening injury. Road safety interventions targeting young males are likely to reduce trauma. © 2013 Royal Australasian College of Surgeons.

  9. 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.

  10. Studies of FCAPT uvby Photometry of mCP Stars with Period04

    NASA Astrophysics Data System (ADS)

    Adelman, Saul Joseph; Jones Dukes, Robert

    2015-08-01

    We present differential Stromgren uvby observations of a few magnetic Chemically Peculiar (mCP) Stars from the Four College Automated Photometric Telescope to illustrate some interesting results found using Period04. Without an observer monitoring the weather, quality control depends on a several part process of closely inspecting the data. For each star we found a preliminary rotation period from the periodograms of the 4 filters and then used the accompanying non-linear least square tool to refine it. Next we repeated the analysis on the residuals from the fit to determine other periods. Usually we found the higher harmonics for those stars with non-sinusoidal light curves. In at least two cases there were low frequency terms.These high quality datasets usually have a greater number of yearly values obtained over more observing seasons than published studies. Stromgren intermediate bandwidth filters have mean wavelengths of λ3500 for u, λ4410 for v, λ4650 for b, and λ5470 for y with halfwidths of 300, 190, 180, and 230 Angstroms, respectively. The v and y values are often affected by broad, continuum features centered near λ4200 and λ5200.The mCP stars have non-aligned rotation and magnetic axes with emergent energy distributions, abundances, and magnetic field strengths being functions of photospheric position. Most have dipolar magnetic fields. Hydrodynamical processes, including radiative diffusion and gravitational settling, act in the radiative envelope to modify the elemental abundances relative to solar values. When such a star rotates, a distant observer often can see photometric, spectrum, and/or magnetic variability. Detecting one of these types of variability for a star with a mCP spectral classification means that it also varies in the other two ways which may not be easy to detect.Some particularly interesting results includeHD 5797 whose v variation is unique in having both the smallest amplitude and an apparent period one-half the period

  11. Dying of corruption.

    PubMed

    Holmberg, Sören; Rothstein, Bo

    2011-10-01

    In many poor countries, over 80% of the population have experienced corrupt practices in the health sector. In rich countries, corruption takes other forms such as overbilling. The causal link between low levels of the quality of government (QoG) and population health can be either direct or indirect. Using cross-sectional data from more than 120 countries, our findings are that more of a QoG variable is positively associated with higher levels of life expectancy, lower levels of mortality rates for children and mothers, higher levels of healthy life expectancies and higher levels of subjective health feelings. In contrast to the strong relationships between the QoG variables and the health indicators, the relationship between the health-spending measures and population health are rather weak most of the time and occasionally non-existent. Moreover, for private health spending as well as for private share of total health spending, the relation to good health is close to zero or slightly negative. The policy recommendation coming out of our study to improve health levels around the world, in rich countries as well as in poor countries, is to improve the QoG and to finance health care with public, not private, money.

  12. Experimental Study of the Effects of Periodic Unsteady Wakes on Flow Separation in Low Pressure Turbines

    NASA Technical Reports Server (NTRS)

    Ozturk, Burak; Schobeiri, Meinhard T.

    2009-01-01

    The present study, which is the first of a series of investigations of low pressure turbine (LPT) boundary layer aerodynamics, is aimed at providing detailed unsteady boundary layer flow information to understand the underlying physics of the inception, onset, and extent of the separation zone. A detailed experimental study on the behavior of the separation zone on the suction surface of a highly loaded LPT-blade under periodic unsteady wake flow is presented. Experimental investigations were performed on a large-scale, high-subsonic unsteady turbine cascade research facility with an integrated wake generator and test section unit. Blade Pak B geometry was used in the cascade. The wakes were generated by continuously moving cylindrical bars device. Boundary layer investigations were performed using hot wire anemometry at Reynolds number of 110,000, based on the blade suction surface length and the exit velocity, for one steady and two unsteady inlet flow conditions, with the corresponding passing frequencies, wake velocities, and turbulence intensities. The reduced frequencies cover the entire operation range of LP-turbines. In addition to the unsteady boundary layer measurements, blade surface pressure measurements were performed at Re = 50,000, 75,000, 100,000, 110,000, and 125,000. For each Reynolds number, surface pressure measurements are carried out at one steady and two periodic unsteady inlet flow conditions. Detailed unsteady boundary layer measurement identifies the onset and extension of the separation zone as well as its behavior under unsteady wake flow. The results, presented in ensemble-averaged and contour plot forms, help to understand the physics of the separation phenomenon under periodic unsteady wake flow.

  13. Case study: Nutrition and training periodization in three elite marathon runners.

    PubMed

    Stellingwerf, Trent

    2012-10-01

    Laboratory-based studies demonstrate that fueling (carbohydrate; CHO) and fluid strategies can enhance training adaptations and race-day performance in endurance athletes. Thus, the aim of this case study was to characterize several periodized training and nutrition approaches leading to individualized race-day fluid and fueling plans for 3 elite male marathoners. The athletes kept detailed training logs on training volume, pace, and subjective ratings of perceived exertion (RPE) for each training session over 16 wk before race day. Training impulse/load calculations (TRIMP; min × RPE = load [arbitrary units; AU]) and 2 central nutritional techniques were implemented: periodic low-CHO-availability training and individualized CHO- and fluid-intake assessments. Athletes averaged ~13 training sessions per week for a total average training volume of 182 km/wk and peak volume of 231 km/wk. Weekly TRIMP peaked at 4,437 AU (Wk 9), with a low of 1,887 AU (Wk 16) and an average of 3,082 ± 646 AU. Of the 606 total training sessions, ~74%, 11%, and 15% were completed at an intensity in Zone 1 (very easy to somewhat hard), Zone 2 (at lactate threshold) and Zone 3 (very hard to maximal), respectively. There were 2.5 ± 2.3 low-CHO-availability training bouts per week. On race day athletes consumed 61 ± 15 g CHO in 604 ± 156 ml/hr (10.1% ± 0.3% CHO solution) in the following format: ~15 g CHO in ~150 ml every ~15 min of racing. Their resultant marathon times were 2:11:23, 2:12:39 (both personal bests), and 2:16:17 (a marathon debut). Taken together, these periodized training and nutrition approaches were successfully applied to elite marathoners in training and competition.

  14. "Radiative Closure Studies for Clear Skies During the ARM 2003 Aerosol Intensive Observation Period"

    SciTech Connect

    J. J. Michalsky, G. P. Anderson, J. Barnard, J. Delamere, C. Gueymard, S. Kato, P. Kiedron, A. McComiskey, and P. Ricchiazzi

    2006-04-01

    The Department of Energy's Atmospheric Radiation Measurement (ARM) program sponsored a large intensive observation period (IOP) to study aerosol during the month of May 2003 around the Southern Great Plains (SGP) Climate Research Facility (CRF) in north central Oklahoma. Redundant measurements of aerosol optical properties were made using different techniques at the surface as well as in vertical profile with sensors aboard two aircraft. One of the principal motivations for this experiment was to resolve the disagreement between models and measurements of diffuse horizontal broadband shortwave irradiance at the surface, especially for modest aerosol loading. This paper focuses on using the redundant aerosol and radiation measurements during this IOP to compare direct beam and diffuse horizontal broadband shortwave irradiance measurements and models at the surface for a wide range of aerosol cases that occurred during 30 clear-sky periods on 13 days of May 2003. Models and measurements are compared over a large range of solar-zenith angles. Six different models are used to assess the relative agreement among them and the measurements. Better agreement than previously achieved appears to be the result of better specification of input parameters and better measurements of irradiances than in prior studies. Biases between modeled and measured direct irradiances are less than 1%, and biases between modeled and measured diffuse irradiances are less than 2%.

  15. Study of deformed quasi-periodic Fibonacci two dimensional photonic crystals

    NASA Astrophysics Data System (ADS)

    Ben Abdelaziz, K.; Bouazzi, Y.; Kanzari, M.

    2015-09-01

    Quasi-periodic photonic crystals are not periodic structures. These structures are generally obtained by the arrangement of layers according to a recursive rule. Properties of these structures make more attention the researchers especially in the case when applying defects. So, photonic crystals with defects present localized modes in the band gap leading to many potential applications such light localization. The objective of this work is to study by simulation the effect of the global deformation introduced in 2D quasiperiodic photonic crystals. Deformation was introduced by applying a power law, so that the coordinates y of the deformed object were determined through the coordinates x of the non-deformed structure in accordance with the following rule: y = x1+k. Here k is the coefficient defining the deformation. Therefore, the objective is to study the effect of this deformation on the optical properties of 2D quasiperiodic photonic crystals, constructed by Fibonacci generation. An omnidirectional mirror was obtained for optimization Fibonacci iteration in a part of visible spectra.

  16. Study on the Period of the Use of Datong-li in Korea

    NASA Astrophysics Data System (ADS)

    Lee, Ki-Won; Ahn, Young-Sook; Mihn, Byeong-Hee; Lim, Young-Ryan

    2010-03-01

    It has been generally known that Datong-li (a Chinese calendar in the Ming dynasty)was first introduced into Korea in the nineteenth reign of King Gongmin (1370) of the Goryeo dynasty and lasted to the third reign of King Hyeojong (1652) of the Joseon dynasty. This understanding is based on the records of Goryeo-sa (History of the Goryeo dynasty) and of Seoungwan-ji (Official book of Seoungwan)/ Jeungbomunheon bigo (Explanatory Notes of Library ocument). To verify the period of the use of Datong-li in Korea, we develop a Fortran code to calculate the calendar day by Datong-li and also investigate historical literatures and extant almanacs. As a result, we find the possibility that Datong-li had been in use since 1389 at least. However,we cannot confirm whether Datong-li was first enforced in 1370 or not. On the other hand, we confirm that Datong-li was used until 1653 and reintroduced during the period from 1667 to 1669. Also, we find that previous studies had some errors in the sexagenary cycle of the real first day of a month. We think that this study will contribute to understanding the calendrical history of the Joseon dynasty.

  17. A morphometric study of the human endometrial stroma during the peri-implantation period.

    PubMed

    Dockery, P; Warren, M A; Li, T C; Rogers, A W; Cooke, I D; Mundy, J

    1990-02-01

    In this study we have examined the human endometrial stromal cell population in well-timed biopsies during the peri-implantation period, using traditional stereological techniques. This paper reports data obtained from 16 women of known fertility who underwent endometrial biopsies at known times after the luteinizing hormone (LH) surge (four each at LH + 2, LH + 4, LH + 6 and LH + 8). The average stromal cell nuclear diameter increased in size throughout the period of study (P less than 0.01), with a significant decrease (P less than 0.05) in the nuclear profile axial ratio. This suggests that the nuclei were increasing in size and becoming more rounded. There was a dramatic increase (P less than 0.01) in the packing density between LH + 2 and LH + 6; this is likely to be due, at least in part, to the glands filling up with secretory products and so compressing the intervening stroma. A substantial decrease (P less than 0.01) was seen in the packing density between LH + 6 and LH + 8. This corresponds to the time when stromal oedema is thought to be maximal.

  18. A morphometric study of the human endometrial stroma during the peri-implantation period.

    PubMed

    Dockery, P; Warren, M A; Li, T C; Rogers, A W; Cooke, I D; Mundy, J

    1990-07-01

    In this study we have examined the human endometrial stromal cell population in well-timed biopsies during the peri-implantation period, using traditional stereological techniques. This paper reports data obtained from 16 women of known fertility who underwent endometrial biopsies at known times after the luteinizing hormone (LH) surge (four each at LH + 2, LH + 4, LH + 6 and LH + 8). The average stromal cell nuclear diameter increased in size throughout the period of study (P less than 0.01), with a significant decrease (P less than 0.05) in the nuclear profile axial ratio. This suggests that the nuclei were increasing in size and becoming more rounded. There was a dramatic increase (P less than 0.01) in the rounded. There was a dramatic increase (P less than 0.01) in the packing density between LH + 2 and LH + 6; this is likely to be due, at least in part, to the glands filling up with secretory products and so compressing the intervening stroma. A substantial decrease (P less than 0.01) was seen in the packing density between LH + 6 and LH + 8. This corresponds to the time when stromal oedema is thought to be maximal.

  19. Emergence periodicity of Phlebotomus argentipes annandale and brunetti (Diptera: psychodidae): A laboratory study.

    PubMed

    Dinesh, D S; Singh, A; Kumar, V; Kesari, S; Kumar, A J; Kishore, K; Roy, S P; Bhattacharya, S K; Das, P

    2009-12-01

    Phlebotomus argentipes Annandale and Brunetti (Diptera: Psychodidae) is the vector for visceral leishmaniasis in India. The aspects of its biology such as feeding and man vector contact are associated with emergence periodicity of the adult. Hence, the present study was made to find out the actual emergence period of P. argentipes. Wild caught P. argentipes were confined in the rearing pots inside laboratory. The newly emerged adults were collected at hourly intervals and released in to separate polythene bags and were held at 4°C till death. Sand flies were segregated sex-wise after the death under a microscope. The emergence of adult was observed throughout the day. However, the male preferred dawn emergence and the female the dusk. Two peaks of emergence were found in a day; first one in the morning (0900h) and the second one in the evening (1800h). The ratio of both sexes was found to be about equal. The emergence of adult was found to be 77% out of total eggs laid, which was completed within 7-10 days from the 1st day of emergence under laboratory conditions (25°C to 31°C and 70% to 75% relative humidity). This study has important bearings to find out the actual time for personal protection against biting of sand flies to prevent the transmission of Kala-azar.

  20. A Study on Effects of Waiting Period in Software Operation on the Operator's Psychophysiological State

    NASA Astrophysics Data System (ADS)

    Hayasaka, Yoshiaki; Kimura, Tatsuhiro; Segawa, Norihisa; Miyazaki, Masatoshi; Yamazaki, Kiyoyuki; Murayama, Yuko

    The authors have been studying psychophysiological workload of human interface (HI) with physiological measurements and analysis. In this study, we investigated a kind of mental workload produced by user's unexpected waiting period from the request input to the termination of data processing during personal computer (PC) operation. As the experimental setting of HI, we used interactive software containing easy questions with unexpected time interval between each question. The effects of progress indicator (PI) indicating during waiting period on psychophysiological status of users were analyzed by using respiration, finger plethysmogram (PTG), heart rate (HR) and electroencephalogram (EEG) measurements. Results showed that the theta wave component of the EEG increased in the non-PI condition, even though autonomic nervous system parameters showed no significant change. Negative correlation between preference score for HI and integrated theta component percentage was observed only in non-PI condition. It is supposed that the PI was controlling theta activity coused by waiting stress in experimental condition. Utilizing physiological indices for HI assessment, this experimental method could be available to waiting stress estimation.

  1. Where the elderly die: the influence of socio-demographic factors and cause of death on people dying at home.

    PubMed

    Beng, Arthur K L; Fong, Chee Weng; Shum, Eugene; Goh, Cynthia R; Goh, Kee Tai; Chew, Suok Kai

    2009-08-01

    The place of death of the elderly has implications on the overall healthcare delivery system. The aim of this study is to describe where deaths of elderly occur in Singapore and to determine the association of socio-demographic characteristics and the causes of death on dying at home. Data of 10,399 Singapore resident decedents aged 65 years and above in 2006 were obtained from the national Registry of Births and Deaths. Distributions of socio-demographic characteristics and causes of death by place of death were analysed, and associations between socio-demographic characteristics and home death for major causes of death were assessed by logistic regression models controlling for age, gender and ethnic group. Most elderly deaths occurred in hospitals (57%), followed by deaths at home (31%). The proportion of deaths at home increased with age while deaths in hospital declined with age. Significantly more elderly women died at home compared to men. Malay elderly had the highest proportion of home deaths (49%), and the lowest proportion of hospital deaths (47%). Elderly persons who died from stroke were most likely to die at home [odds ratio (OR) 2.8, 95% confidence interval (CI), 2.3-3.3] while those who died from lung and respiratory system diseases were less likely to die at home (OR, 0.7; 95% CI, 0.6-0.8). Elderly people in Singapore die mainly in hospitals. About a third of them die at home. The proportion of decedents dying at home increased with age. Home deaths among the elderly are most likely in those aged 85 years and above, females, Malays, and those who die of stroke.

  2. Musculoskeletal symptoms and job strain among nursing personnel: a study over a three year period.

    PubMed Central

    Josephson, M; Lagerström, M; Hagberg, M; Wigaeus Hjelm, E

    1997-01-01

    OBJECTIVES: To examine the variation of symptoms from the neck, shoulders, and back over a three year period among female nursing personnel and the relation between job strain and musculoskeletal symptoms. METHODS: At a county hospital the female nursing personnel answered a questionnaire at baseline and then once a year over a period of three years. There were 565, 553, 562, and 419 subjects who answered the questionnaire at the first, second, third, and fourth survey, respectively. Of the study group, 285 nursing personnel answered the questionnaire on four occasions. Ongoing symptoms of the neck, shoulders, and back were assessed by means of a 10 point (0-9) scale with the verbal end points "no symptoms" and "very intense symptoms." Cases were defined as nursing personnel reporting ongoing symptoms, score > 6, from at least one of the body regions. For assessments of job strain, a Swedish version of Karasek and Theorell's model was used. RESULTS: Of the 285 subjects, 13% were defined as cases at all four assessments, and 46% varied between cases and not cases during the study period. In the repeated cross sectional surveys the estimated rate ratio (RR) for being a case was between 1.1 and 1.5 when comparing the group with job strain and the group without job strain. For the combination of job strain and perceived high physical exertion the estimated RR was between 1.5 and 2.1. When the potential risk factors were assessed one, two, or three years before the assessment of symptoms the estimated RR for becoming a case was between 1.4 and 2.2 when comparing the group with job strain and the group without job strain. CONCLUSION: Almost half of the healthcare workers varied between being a case and not, over a three year period. The analysis indicated that job strain is a risk factor for musculoskeletal symptoms and that the risk is higher when it is combined with perceived high physical exertion. PMID:9423583

  3. 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,…

  4. A Simulation Based on Goldratt's Matchstick/Die Game

    ERIC Educational Resources Information Center

    Martin, Clarence H.

    2007-01-01

    This teaching brief presents a Microsoft® Excel simulation designed to complement and expand upon the well-known matchstick/die game introduced by Goldratt in "The Goal." This simulation performs 100 replications of a 40-period processing run for low, medium, and high levels of process variation and displays the comparative results…

  5. 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,…

  6. Crystal scale anatomy of a dying supervolcano: an isotope and geochronology study of individual phenocrysts from voluminous rhyolites of the Yellowstone caldera

    NASA Astrophysics Data System (ADS)

    Watts, Kathryn E.; Bindeman, Ilya N.; Schmitt, Axel K.

    2012-07-01

    A voluminous (>600 km3) and long-lived (~520-75 ka) phase of rhyolitic eruptions followed collapse of the Yellowstone caldera 640 ka. Whether these eruptions represent a dying cycle, or the growth of a new magma chamber, remains an important question. We use new U-Th zircon ages and δ18O values determined by ion microprobe, and sanidine Pb isotope ratios determined by laser ablation, to investigate the genesis of voluminous post-caldera rhyolites. The oldest post-caldera rhyolites, erupted between ~520 and 470 ka, exhibit extreme age and oxygen isotopic heterogeneity, requiring derivation from individual parcels of low-δ18O melts. We find a progressive increase in zircon homogeneity for rhyolite eruptions from ~260 to 75 ka, with homogeneous low-δ18O zircon values of 2.7-2.8‰ that are in equilibrium with low-δ18O host melts for the majority of the youngest eruptions. New sanidine Pb isotope data define separate arrays for post-caldera rhyolites and the caldera-forming tuffs that preceded them, indicating that they were not sourced from a mushy Lava Creek Tuff batholith that remained after caldera collapse. Rather, our new age and isotopic data indicate that the post-caldera rhyolites were generated by remelting of a variety of intracaldera source rocks, consisting of pre-Lava Creek Tuff volcanic and plutonic rocks and earlier erupted post-Lava Creek Tuff rhyolites. Batch assembly of low-δ18O melts starting at ~260 ka resulted in progressive homogenization, followed by differentiation and cooling up until the last rhyolite eruption ~75 ka, a trend that we interpret to be characteristic of a dying magma reservoir beneath the Yellowstone caldera.

  7. An ab initio periodic study of acidic chabazite as a candidate for dihydrogen storage.

    PubMed

    Torres, F J; Civalleri, B; Pisani, C; Ugliengo, P

    2006-06-01

    A theoretical B3LYP study, adopting a polarized double-zeta quality Gaussian basis set, was performed to characterize acidic chabazite by using the periodic CRYSTAL03 program. Different Si/Al loadings (1/1, 3/1, 5/1, and 11/1) were considered, and for each of them the most stable aluminum distribution and location of the acidic proton, needed as charge balancer, were identified. With the optimal structures, the energy of formation and the anharmonic O-H stretching frequency were calculated with the latter being in good agreement with the experimental data. The B3LYP optimal position of H2 physisorbed at the acidic Brönsted sites of chabazite (Si/Al = 11/1 and 5/1) brings about an interaction energy definitely smaller than that derived from infrared spectroscopy, because of the known deficiencies of this functional to cope with dispersive interactions. The latter was included by means of an ONIOM-like procedure that combines periodic B3LYP energy with results at the MP2 level on selected clusters cut out of the chabazite framework. Adsorption of two H2 molecules for Si/Al = 5/1 chabazite showed a complete independence of each Brönsted site, and neither through-space nor intrastructure polarization effects are present. Within the periodic B3LYP approach shifts in both O-H and H-H anharmonic frequencies were also computed and compared with unperturbed values and with the available experimental results.

  8. A comprehensive study for the plasmonic thin-film solar cell with periodic structure.

    PubMed

    Sha, Wei E I; Choy, Wallace C H; Chew, Weng Cho

    2010-03-15

    A comprehensive study of the plasmonic thin-film solar cell with the periodic strip structure is presented in this paper. The finite-difference frequency-domain method is employed to discretize the inhomogeneous wave function for modeling the solar cell. In particular, the hybrid absorbing boundary condition and the one-sided difference scheme are adopted. The parameter extraction methods for the zeroth-order reflectance and the absorbed power density are also discussed, which is important for testing and optimizing the solar cell design. For the numerical results, the physics of the absorption peaks of the amorphous silicon thin-film solar cell are explained by electromagnetic theory; these peaks correspond to the waveguide mode, Floquet mode, surface plasmon resonance, and the constructively interference between adjacent metal strips. The work is therefore important for the theoretical study and optimized design of the plasmonic thin-film solar cell.

  9. Ultrafast time dynamics studies of periodic lattices with free electron laser radiation

    SciTech Connect

    Quevedo, W.; Busse, G.; Hallmann, J.; More, R.; Petri, M.; Rajkovic, I.; Krasniqi, F.; Rudenko, A.; Tschentscher, T.; Stojanovic, N.; Duesterer, S.; Treusch, R.; Tolkiehn, M.; Techert, S.

    2012-11-01

    It has been proposed that radiation from free electron laser (FEL) at Hamburg (FLASH) can be used for ultrafast time-resolved x-ray diffraction experiments based on the near-infrared (NIR) pump/FEL probe scheme. Here, investigation probing the ultrafast structural dynamics of periodic nano-crystalline organic matter (silver behenate) with such a scheme is reported. Excitation with a femtosecond NIR laser leads to an ultrafast lattice modification which time evolution has been studied through the scattering of vacuum ultraviolet FEL pulses. The found effect last for 6 ps and underpins the possibility for studying nanoperiodic dynamics down to the FEL source time resolution. Furthermore, the possibility of extending the use of silver behenate (AgBh) as a wavelength and temporal calibration tool for experiments with soft x-ray/FEL sources is suggested.

  10. Experimental study of fs-laser induced sub-100-nm periodic surface structures on titanium.

    PubMed

    Nathala, Chandra S R; Ajami, Ali; Ionin, Andrey A; Kudryashov, Sergey I; Makarov, Sergey V; Ganz, Thomas; Assion, Andreas; Husinsky, Wolfgang

    2015-03-09

    In this work the formation of laser-induced periodic surface structures (LIPSS) on a titanium surface upon irradiation by linearly polarized femtosecond (fs) laser pulses with a repetition rate of 1 kHz in air environment was studied experimentally. In particular, the dependence of high-spatial-frequency-LIPSS (HSFL) characteristics on various laser parameters: fluence, pulse number, wavelength (800 nm and 400 nm), pulse duration (10 fs - 550 fs), and polarization was studied in detail. In comparison with low-spatial-frequency-LIPSS (LSFL), the HSFL emerge at a much lower fluence with orientation perpendicular to the ridges of the LSFL. It was observed that these two types of LIPSS demonstrate different fluence, shot number and wavelength dependencies, which suggest their origin is different. Therefore, the HSFL formation mechanism cannot be described by the widely accepted interference model developed for describing LSFL formation.

  11. Epidemiology of injuries in elite taekwondo athletes: two Olympic periods cross-sectional retrospective study.

    PubMed

    Altarriba-Bartes, Albert; Drobnic, Franchek; Til, Lluís; Malliaropoulos, Nikolaos; Montoro, José Bruno; Irurtia, Alfredo

    2014-02-14

    Taekwondo injuries differ according to the characteristics of the athletes and the competition. This analytical cross-sectional retrospective cohort study aimed to describe reported taekwondo injuries and to determine the prevalence, characteristics and possible risk factors for injuries sustained by athletes of the Spanish national team. In addition, we compared each identified risk factor-age, weight category, annual quarter, injury timing and competition difficulty level-with its relation to injury location and type. Injury occurrences in taekwondo athletes of the Spanish national team during two Olympic periods at the High Performance Centre in Barcelona were analysed. 48 taekwondo athletes (22 male, 26 female; age range 15-31 years) were studied; 1678 injury episodes occurred. Inclusion criteria were: (1) having trained with the national taekwondo group for a minimum of one sports season; (2) being a member of the Spanish national team. Independently of sex or Olympic period, the anatomical sites with most injury episodes were knee (21.3%), foot (17.0%), ankle (12.2%), thigh (11.4%) and lower leg (8.8%). Contusions (29.3%) and cartilage (17.6%) and joint (15.7%) injuries were the prevalent types of injury. Chronological age, weight category and annual quarter can be considered risk factors for sustaining injuries in male and female elite taekwondists according to their location and type (p≤0.001). This study provides epidemiological information that will help to inform future injury surveillance studies and the development of prevention strategies and recommendations to reduce the number of injuries in taekwondo competition.

  12. Epidemiology of injuries in elite taekwondo athletes: two Olympic periods cross-sectional retrospective study

    PubMed Central

    Altarriba-Bartes, Albert; Drobnic, Franchek; Til, Lluís; Malliaropoulos, Nikolaos; Montoro, José Bruno; Irurtia, Alfredo

    2014-01-01

    Objective Taekwondo injuries differ according to the characteristics of the athletes and the competition. This analytical cross-sectional retrospective cohort study aimed to describe reported taekwondo injuries and to determine the prevalence, characteristics and possible risk factors for injuries sustained by athletes of the Spanish national team. In addition, we compared each identified risk factor—age, weight category, annual quarter, injury timing and competition difficulty level—with its relation to injury location and type. Settings Injury occurrences in taekwondo athletes of the Spanish national team during two Olympic periods at the High Performance Centre in Barcelona were analysed. Participants 48 taekwondo athletes (22 male, 26 female; age range 15–31 years) were studied; 1678 injury episodes occurred. Inclusion criteria were: (1) having trained with the national taekwondo group for a minimum of one sports season; (2) being a member of the Spanish national team. Results Independently of sex or Olympic period, the anatomical sites with most injury episodes were knee (21.3%), foot (17.0%), ankle (12.2%), thigh (11.4%) and lower leg (8.8%). Contusions (29.3%) and cartilage (17.6%) and joint (15.7%) injuries were the prevalent types of injury. Chronological age, weight category and annual quarter can be considered risk factors for sustaining injuries in male and female elite taekwondists according to their location and type (p≤0.001). Conclusions This study provides epidemiological information that will help to inform future injury surveillance studies and the development of prevention strategies and recommendations to reduce the number of injuries in taekwondo competition. PMID:24531455

  13. Died of wounds: a mortality review.

    PubMed

    Keene, Damian Douglas; Penn-Barwell, J G; Wood, P R; Hunt, N; Delaney, R; Clasper, J; Russell, R J; Mahoney, P F

    2016-10-01

    Combat casualty care is a complex system involving multiple clinicians, medical interventions and casualty transfers. Improving the performance of this system requires examination of potential weaknesses. This study reviewed the cause and timing of death of casualties deemed to have died from their injuries after arriving at a medical treatment facility during the recent conflicts in Iraq and Afghanistan, in order to identify potential areas for improving outcomes. This was a retrospective review of all casualties who reached medical treatment facilities alive, but subsequently died from injuries sustained during combat operations in Afghanistan and Iraq. It included all deaths from start to completion of combat operations. The UK military joint theatre trauma registry was used to identify cases, and further data were collected from clinical notes, postmortem records and coroner's reports. There were 71 combat-related fatalities who survived to a medical treatment facility; 17 (24%) in Iraq and 54 (76%) in Afghanistan. Thirty eight (54%) died within the first 24 h. Thirty-three (47%) casualties died from isolated head injuries, a further 13 (18%) had unsurvivable head injuries but not in isolation. Haemorrhage following severe lower limb trauma, often in conjunction with abdominal and pelvic injuries, was the cause of a further 15 (21%) deaths. Severe head injury was the most common cause of death. Irrespective of available medical treatment, none of this group had salvageable injuries. Future emphasis should be placed in preventative strategies to protect the head against battlefield trauma. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  14. Sample size determination for alternate periods of use study designs with binary responses.

    PubMed

    Morel, Jorge G; Neerchal, Nagaraj K

    2012-01-01

    In this article, we consider several study designs that arise in practice, which are variations of standard crossover designs. Often, they may result from modifications made to a standard crossover design due to practical considerations. Characteristic features of the studies we are concerned with are (a) treatments consist of external use of products with little or no possibility of carry over effects, and (b) the periods of use are dictated by the subjects or by some specific event, such as diaper leakage or menstrual flow. We consider a number of such study designs for estimating the difference in the efficacy of two treatments or test products. We provide brief descriptions of studies to motivate the study design, the underlying data structure, and computations of the variances of the usual unbiased estimators of the difference in efficacy, and the sample size formulas. The situations considered here cover a number of popular crossover designs. The objective of our work is to provide guidance to members of a wide audience on how to answer the sample size question for their own nonstandard situations. We conclude the article with a brief report on a simulation study we conducted to investigate the impact of estimation on the sample size determination and consequently on the actual power realized in an effort to promote the "best practice" of checking whether the recommended sample sizes indeed achieve the desired level of power.

  15. Sexual activity and sexual dysfunction of women in the perinatal period: a longitudinal study.

    PubMed

    Wallwiener, Stephanie; Müller, Mitho; Doster, Anne; Kuon, Ruben Jeremias; Plewniok, Katharina; Feller, Sandra; Wallwiener, Markus; Reck, Corinna; Matthies, Lina Maria; Wallwiener, Christian

    2017-04-01

    Reduced sexual activity and dysfunctional problems are highly prevalent in the perinatal period, and there is a lack of data regarding the degree of normality during pregnancy. Several risk factors have been independently associated with a greater extent of Female Sexual Dysfunction (FSD). Therefore, this study aimed to assess the prevalence of sexual inactivity and sexual dysfunctions in German women during the perinatal period and the verification of potential risk factors. Questionnaires were administered to 315 women prenatally (TI 3rd trimester) and postpartum (TII 1 week, TIII 4 months), including the Female Sexual Function Index (FSFI), the Edinburgh Postnatal Depression Scale (EPDS), and the Questionnaire of Partnership (PFB). The frequency of sexual inactivity was 24% (TI), 40.5% (TII), and 19.9% (TIII). Overall, 26.5-34.8% of women were at risk of sexual dysfunction (FSFI score <26.55) at all measurement points. Sexual desire disorder was the most prevalent form of Female sexual dysfunction. Furthermore, especially breastfeeding and low partnership quality were revealed as significant risk factors for sexual dysfunctional problems postpartum. Depressive symptoms having a cesarean section and high maternal education were correlated with dysfunctional problems in several subdomains. Findings indicated that women at risk of FSD differed significantly in aspects of partnership quality, breastfeeding, mode of delivery, maternal education, and depressive symptoms. Aspects of perinatal sexuality should be routinely implemented in the counseling of couples in prenatal classes.

  16. Detection of (In)activity Periods in Human Body Motion Using Inertial Sensors: A Comparative Study

    PubMed Central

    Olivares, Alberto; Ramírez, Javier; Górriz, Juan M.; Olivares, Gonzalo; Damas, Miguel

    2012-01-01

    Determination of (in)activity periods when monitoring human body motion is a mandatory preprocessing step in all human inertial navigation and position analysis applications. Distinction of (in)activity needs to be established in order to allow the system to recompute the calibration parameters of the inertial sensors as well as the Zero Velocity Updates (ZUPT) of inertial navigation. The periodical recomputation of these parameters allows the application to maintain a constant degree of precision. This work presents a comparative study among different well known inertial magnitude-based detectors and proposes a new approach by applying spectrum-based detectors and memory-based detectors. A robust statistical comparison is carried out by the use of an accelerometer and angular rate signal synthesizer that mimics the output of accelerometers and gyroscopes when subjects are performing basic activities of daily life. Theoretical results are verified by testing the algorithms over signals gathered using an Inertial Measurement Unit (IMU). Detection accuracy rates of up to 97% are achieved. PMID:22778613

  17. A critical period of brain development: studies of cerebral glucose utilization with PET.

    PubMed

    Chugani, H T

    1998-01-01

    Studies with positron emission tomography indicate that the human brain undergoes a period of postnatal maturation that is much more protracted than previously suspected. In the newborn, the highest degree of glucose metabolism (representative of functional activity) is in primary sensory and motor cortex, cingulate cortex, thalamus, brain stem, cerebellar vermis, and hippocampal region. At 2 to 3 months of age, glucose utilization increases in the parietal, temporal, and primary visual cortex; basal ganglia; and cerebellar hemispheres. Between 6 and 12 months, glucose utilization increases in frontal cortex. These metabolic changes correspond to the emergence of various behaviors during the first year of life. The measurement of absolute rates of glucose utilization during development indicates that the cerebral cortex undergoes a dynamic course of metabolic maturation that persists until ages 16-18 years. Initially, there is a rise in the rates of glucose utilization from birth until about age 4 years, at which time the child's cerebral cortex uses over twice as much glucose as that of adults. From age 4 to 10 years, these very high rates of glucose consumption are maintained, and only after then is there a gradual decline of glucose metabolic rates to reach adult values by age 16-18 years. Correlations between glucose utilization rates and synaptogenesis are discussed, and the argument is made that these findings have important implications with respect to human brain plasticity following injury as well as to "critical periods" of maximal learning capacity.

  18. Detection of (in)activity periods in human body motion using inertial sensors: a comparative study.

    PubMed

    Olivares, Alberto; Ramírez, Javier; Górriz, Juan M; Olivares, Gonzalo; Damas, Miguel

    2012-01-01

    Determination of (in)activity periods when monitoring human body motion is a mandatory preprocessing step in all human inertial navigation and position analysis applications. Distinction of (in)activity needs to be established in order to allow the system to recompute the calibration parameters of the inertial sensors as well as the Zero Velocity Updates (ZUPT) of inertial navigation. The periodical recomputation of these parameters allows the application to maintain a constant degree of precision. This work presents a comparative study among different well known inertial magnitude-based detectors and proposes a new approach by applying spectrum-based detectors and memory-based detectors. A robust statistical comparison is carried out by the use of an accelerometer and angular rate signal synthesizer that mimics the output of accelerometers and gyroscopes when subjects are performing basic activities of daily life. Theoretical results are verified by testing the algorithms over signals gathered using an Inertial Measurement Unit (IMU). Detection accuracy rates of up to 97% are achieved.

  19. Study of electromagnetic wave scattering by periodic density irregularities in plasma

    SciTech Connect

    Lyle, R.; Kuo, S.P.; Huang, J.

    1995-12-31

    A quasi-particle approach is used to formulate wave propagation and scattering in a periodically structured plasma. The theory is then applied to study the effect of bottomside sinusoidal (BSS) irregularities on the propagation of beacon satellites signals through the ionosphere. In this approach, the radio wave is treated as a distribution of quasi-particles described by a Wigner distribution function governed by a transport equation. The irregularities providing the collisional effect are modeled as a two dimensional density modulation on a uniform background plasma. The present work generalizes the previous work by including the spectral bandwidth ({Delta}k/k) effect of the spatially periodic irregularities on the transionospheric signal propagation. The collision of quasi-particles with the irregularities modifies the quasi-particle distribution and give rise to the wave scattering phenomenon. The multiple scattering process is generally considered in this deterministic analysis of radio wave scattering off the ionospheric density irregularities. The analysis shows that this two dimensional density grating effectively modulates the intensity of the beacon satellite signals. This spatial modulation of the wave intensity is converted into time modulation due to the drift of the ionospheric irregularities, which then results in the scintillation of the beacon satellite signals.

  20. Application of Magnetic Kinds of Nondestructive Inspection to Parts From Die Tool Steels

    NASA Astrophysics Data System (ADS)

    Kornilova, A. V.; Selishchev, A. I.; Idarmachev, I. M.

    2016-01-01

    Possibilities of control of the level of accumulated damage in dies for cold and hot forming as a function of the coercivity are considered. The coercivity of the material of dies for hot forging and cold stamping is studied. Formulas are obtained for determining the coercivity in steels for hot die forging in the state as delivered.

  1. Increasing Incidence of Herpes Zoster Over a 60-year Period From a Population-based Study.

    PubMed

    Kawai, Kosuke; Yawn, Barbara P; Wollan, Peter; Harpaz, Rafael

    2016-07-15

    Temporal increases in the incidence of herpes zoster (HZ) have been reported but studies have examined short study periods, and the cause of the increase remains unknown. We examined the long-term trend of HZ. A population-based cohort study was conducted in Olmsted County, Minnesota, using data from 1945-1960 and 1980-2007. Medical records review of possible cases was performed to confirm incident cases of HZ, the patient's immune status, and prescribing of antivirals for HZ. We examined the relative change in the temporal trend in the incidence rates before and after the introduction of the varicella vaccination program. Of the 8017 patients with HZ, 58.7% were females and 6.6% were immunocompromised. The age- and sex-adjusted incidence rate of HZ increased from 0.76 per 1000 person-years (PY) (95% confidence interval [CI], .63-.89) in 1945-1949 to 3.15 per 1000 PY (95% CI, 3.04-3.26) in 2000-2007. The rate of increase across the time period was 2.5% per year after adjusting for age and sex (adjusted incidence rate ratio, 1.025 [95% CI, 1.023-1.026]; P < .001). The incidence of HZ significantly increased among all age groups and both sexes. We found no change in the rate of increase before vs after the introduction of the varicella vaccination program. The incidence of HZ has increased >4-fold over the last 6 decades. This increase is unlikely to be due to the introduction of varicella vaccination, antiviral therapy, or change in the prevalence of immunocompromised individuals. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  2. Increasing Incidence of Herpes Zoster Over a 60-year Period From a Population-based Study

    PubMed Central

    Kawai, Kosuke; Yawn, Barbara P.; Wollan, Peter; Harpaz, Rafael

    2016-01-01

    Background. Temporal increases in the incidence of herpes zoster (HZ) have been reported but studies have examined short study periods, and the cause of the increase remains unknown. We examined the long-term trend of HZ. Methods. A population-based cohort study was conducted in Olmsted County, Minnesota, using data from 1945–1960 and 1980–2007. Medical records review of possible cases was performed to confirm incident cases of HZ, the patient's immune status, and prescribing of antivirals for HZ. We examined the relative change in the temporal trend in the incidence rates before and after the introduction of the varicella vaccination program. Results. Of the 8017 patients with HZ, 58.7% were females and 6.6% were immunocompromised. The age- and sex-adjusted incidence rate of HZ increased from 0.76 per 1000 person-years (PY) (95% confidence interval [CI], .63–.89) in 1945–1949 to 3.15 per 1000 PY (95% CI, 3.04–3.26) in 2000–2007. The rate of increase across the time period was 2.5% per year after adjusting for age and sex (adjusted incidence rate ratio, 1.025 [95% CI, 1.023–1.026]; P < .001). The incidence of HZ significantly increased among all age groups and both sexes. We found no change in the rate of increase before vs after the introduction of the varicella vaccination program. Conclusions. The incidence of HZ has increased >4-fold over the last 6 decades. This increase is unlikely to be due to the introduction of varicella vaccination, antiviral therapy, or change in the prevalence of immunocompromised individuals. PMID:27161774

  3. Nationwide study of childhood celiac disease incidence over a 35-year period in Estonia.

    PubMed

    Ress, Krista; Luts, Katrin; Rägo, Tiina; Pisarev, Heti; Uibo, Oivi

    2012-12-01

    The aims of the study were to analyze the trends and characteristics of the incidence and clinical presentation of childhood celiac disease (CD) from 1976 to 2010 in Estonia. The study included all children up to 19 years of age diagnosed with small bowel biopsy proven CD. During a 35-year period, CD was diagnosed in 152 children in Estonia (68 boys, median age 2.3 years). From 1976 to 1980, the age-standardized incidence rate of CD was 0.10 per 100,000 person-years. After the introduction of gliadin and endomysium antibody screening (in conjunction with activities directed to increase the physicians awareness), the incidence rate increased from 0.48 in 1986-1990 to 1.55 per 100,000 person-years in 1991-1995. After initiating screening with anti-tissue transglutaminase antibodies in 2003 and routine screening for CD among all children with newly diagnosed type 1 diabetes in 2005, the incidence rate increased from 1.59 in 2001-2005 to 3.14 per 100,000 person-years in 2006-2010 (median age 6.8 years). Our nationwide study demonstrates a more than 30-fold increase in the incidence of childhood CD over a 35-year period in Estonia, along with changing patterns in the presentation of pediatric CD. In addition to the impact of use of novel CD screening methods, active search and rising of the awareness among doctors may have strongest effect. Both environmental and social factors could be also involved in the increase in CD incidence.

  4. Fear of dying and inflammation following acute coronary syndrome.

    PubMed

    Steptoe, Andrew; Molloy, Gerard J; Messerli-Bürgy, Nadine; Wikman, Anna; Randall, Gemma; Perkins-Porras, Linda; Kaski, Juan Carlos

    2011-10-01

    Many patients are afraid of dying during acute coronary syndrome (ACS), but the origins and biological correlates of these emotional responses are poorly understood. This study evaluated the prevalence of fear of dying, associations with inflammatory responses during ACS, and later heart rate variability (HRV) and cortisol secretion. Two hundred and eight patients admitted with clinically verified ACS rated their fear of dying on interview in hospital. Plasma tumour necrosis factor (TNF)α was recorded on admission, and HRV and salivary cortisol were assessed 3 weeks later. Intense distress and fear of dying was experienced by 21.7%, with moderate levels in 66.1% patients. Fear of dying was more common in younger, lower socioeconomic status, and unmarried patients. It was positively associated with plasma TNFα on admission after controlling for sociodemographic factors, clinical risk, and pain intensity (adjusted odds = 4.67, 95% C.I. 1.66-12.65). TNFα was associated with reduced HRV 3 weeks later, adjusting for clinical and sociodemographic factors and medication (P = 0.019), while fear of dying was associated with reduced cortisol output (P = 0.004). Intense distress and fear of dying and heightened inflammation may be related manifestations of an acute biobehavioural response to severe cardiac injury, and have implications for prognostically significant biological risk processes.

  5. Primary prevention in health care employees: a prospective intervention study with a 3-year training period.

    PubMed

    Löffler, Harald; Bruckner, Thomas; Diepgen, Thomas; Effendy, Isaak

    2006-04-01

    Irritant contact dermatitis is a mayor problem in health care employees. Because educational programs have shown convincing success in certain occupations (e.g. in hairdressers), this study investigates the effect of a special training program in health care trainees. 521 trainees from 14 nursing schools in Central Germany were randomly divided in 2 groups, (i) an intervention group with a regular teaching protocol regarding all aspects of primary prevention and (ii) a control group without any further teaching. Morphological changes of the hands, use of hand care creams and knowledge regarding skin care were evaluated regularly during their 3 years lasting training period (1999-2002). In the intervention group, we found at the end of the 3-year training period a significant better skin condition of the hands than in the control group: a 3-year prevalence of morphological skin changes of 66.7% versus 89.3%. The unteached trainees (control group) had an odds ratio (OR) of 4.8 [95% confidential interval (CI): 2.9-7.8] for developing any skin changes on the hands after 3 years. Besides the effect of the teaching, the history of hand dermatitis before the study start was an independent risk factor for development of further hand dermatitis [OR 1.9, 95% CI: 1.0-3.6). Age and sex showed no influence on the skin condition. Atopic constitution had an influence on the development of skin changes only at the evaluation after 18 month. The observed effect in the intervention group may best be explained by different behaviour of the trainees, e.g. the amount of hand washing was reduced, while procedure of hand disinfection remained unchanged compared with the control group. However, the amount of used skin care cream did not differ between the both groups. This study shows that primary prevention of skin disease by regularly teaching during the training period of medical employees can effectively reduce the risk of development of irritant skin changes of the hands. Therefore

  6. Integrated Forming Simulations and Die Structural Analysis for Optimal Die Designs

    NASA Astrophysics Data System (ADS)

    Aitharaju, Venkat; Liu, Malcolm; Dong, Jennifer; Zhang, Jimmy; Wang, Chuan-tao

    2005-08-01

    After gaining a huge success in applying stamping simulations and formability analysis to validate die face developments, GM moves forward to winning total manufacturability in stamping process. Of which, ensuring die structure integrity and minimizing weight is one of the important initiatives. Stamping die design (or solid modeling of stamping dies) was traditionally conducted by following the die design manuals and standards. For any design changes beyond the standards, however, there are no math-based tools available to die designers to verify the outcome of the changes. Die structural analysis (DSA) provides a math-tool to validate the design changes and quantify the safety factors. Several years ago, GM Manufacturing Engineering — Die Center started die structural analysis to meet the increasing demands of customer needs in various areas: (1) to validate design changes; (2) to identify root cause of die breakage during the tryout and stamping operations and propose repair schemes; (3) to optimize the die design for weight reduction; (4) to improve press throughput via optimizing the scrap chute openings, and (5) to provide a math-based tool to validate revisions to the current die design standards. In the integrated forming and die structural analysis, after successful line die surface developments, the forming loads (binder force, pad force, and forming tonnages) are extracted from forming simulations and applied to solid die members for structural analyses of stress, strains, and deflections. In the past few years, Die Center conducted static, dynamic and fatigue analysis for many dies that covers the die design changes requested by die design, die construction and stamping plants. This paper presents some fundamentals and issues of integrated forming and die structural analysis and illustrates the significant impact of die structural analysis on die design, die construction and production stamping.

  7. A comparison of the accuracy of two removable die systems with intact working casts.

    PubMed

    Aramouni, P; Millstein, P

    1993-01-01

    This study evaluated the reproducibility of die position using two removable die systems and two die stones. Poly(vinyl siloxane) impressions were made of a stainless steel, U-shaped arch with four evenly spaced abutments. Six groups were evaluated: Zeiser system/Fuji Rock; Zeiser system/Die Keen; solid cast/Fuji Rock; solid cast/Die Keen; Fuji Rock/Pindex; and Die Keen/Pindex. An optical comparator was used to measure the height of each abutment, the distance between the anterior abutments, and the distance between the posterior abutments. The Zeiser system with either Fuji Rock or Die Keen yielded the greatest accuracy. Die Keen exhibited more linear expansion than Fuji Rock, and solid casts had less distortion than the Pindex system.

  8. Nurses' Involvement in Patients' Dying and Death: Scale development and validation.

    PubMed

    Kondo, Makiko; Nagata, Hiroshi

    2015-01-01

    This study reports the development of a measurement scale, The Nurses' Involvement in Patients' Dying and Death Scale (NIPDYDS), which fully captures the experiences of nurses caring for patients' dying and death. Potential items were extracted from narrative data gathered systematically and comprehensively from in-depth interviews with nurses engaged in caring for patients' dying and death. Factor analyses revealed four factors, consisting of 40 total items, with two factors related to the positive aspects of the experience (Deep involvement in facing dying and death and Increased competence in facing dying and death) and two factors related to the negative aspects of the experience (Uncertainty and difficulty dealing with dying and death and Accustomed to dying and death). Validity and reliability of the scale were found to be acceptable. The factorial structure of the NIPDYDS was contrasted to Frommelt's (1991) FATCOD (The Frommelt Attitude Toward Care of the Dying Scale), and the usefulness and limitations of the NIPDYDS were discussed.

  9. [Quality of dying processes after commencement of the German Living Will Act : Experiences of a surgical intensive care unit].

    PubMed

    Strauss, S; Kuppinger, D; Hartl, W H

    2017-03-01

    There is so far no information on how the third act on amendment of the German guardianship law from 29 July 2009 has affected dying processes of critically ill patients. This retrospective study analyzed the patterns of dying processes in postoperative critically ill patients treated from 2009 to 2012 (period II after the commencement of the German Living Will Act) and 10 years before (period I, 1999-2002). Independent associations were calculated by logistic regression. In the observation period II (n = 137 dying patients) time until death significantly decreased to 19.3 days (95% CI 14.8-23.8, p = 0.008) vs. 29.2 days (95% CI 23.7-34.6) in period I (n = 163). In period II respect of the patient's will preceded death in 42.3% of the dying patients (period I: 8.6%, p < 0.001). Simultaneously, the frequency of patients with a severe preoperative comorbidity (failure of more than one organ) increased (26.8% of dying patients vs. 5.5% in period I, p = 0.001). The treatment during period II was, in addition to high age and a severe comorbidity, a significant independent predictor for the possibility that respect of the patient's will preceded death (odds ratio 7.42; 95% CI 3.77-14.60). Independent of various covariables, treatment after the commencement of the German Living Will Act was associated with a broader and earlier respect of the patient's will, thereby shortening the time until death.

  10. Should assisted dying be legalised?

    PubMed

    Frost, Thomas D G; Sinha, Devan; Gilbert, Barnabas J

    2014-01-15

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

  11. Thermal stability studies of short period Sc/Cr and Sc/B₄C/Cr multilayers.

    PubMed

    Prasciolu, Mauro; Leontowich, Adam F G; Beyerlein, Kenneth R; Bajt, Saša

    2014-04-01

    The stability of short period Sc/Cr and Sc/B₄C/Cr multilayers was investigated over a large temperature range. The aim was to find a stable reflective coating for an off-axis parabola for focusing x rays from a soft x-ray free-electron laser. Normal incidence reflectivity, surface roughness, and intrinsic stress were investigated as a function of annealing temperature and two samples were also studied with a high-resolution transmission electron microscope (TEM), a scanning TEM, and through electron energy loss spectroscopy (EELS). Interface-engineered Sc/B₄C/Cr multilayers showed increased thermal stability and higher reflectivity as compared to pure Sc/Cr multilayers.

  12. Detection specificity studies of bacteriophage adhesin-coated long-period grating-based biosensor

    NASA Astrophysics Data System (ADS)

    Koba, Marcin; Śmietana, Mateusz; Brzozowska, Ewa; Górska, Sabina; Mikulic, Predrag; Cusano, Andrea; Bock, Wojtek J.

    2015-09-01

    In this work, we present a label-free detection specificity study of an optical fiber long-period grating (LPG) biosensor working near the dispersion turning point of higher order cladding modes. The LPG sensor functionalized with bacteriophage adhesin is tested with specific and non-specific bacteria dry weight. We show that such biosensor is able to selectively bind, thus recognize different bacteria. We use bacteria dry weights of E. coli B as positive test and E. coli K12 and Salmonella enterica as negative tests. The resonance wavelength shift induced by E. coli B reaches over 90 nm, while for E. coli K12 and Salmonella enterica approximately 40 and 20 nm, respectively.

  13. Sex and Circadian Periodicity of Cardiovascular Diseases: Are Women Sufficiently Represented in Chronobiological Studies?

    PubMed

    Manfredini, Roberto; Salmi, Raffaella; Cappadona, Rosaria; Signani, Fulvia; Basili, Stefania; Katsiki, Niki

    2017-10-01

    Women are often excluded/underrepresented in clinical trials; sometimes, the number of men/women participants or separate analysis by sex are not reported. A robust body of evidence demonstrated that several life-threatening acute cardiovascular diseases, for example, acute myocardial infarction, sudden cardiac death, cardiac arrest, rupture or dissection of aortic aneurysms, and stroke, exhibit a circadian periodicity with a morning peak. An analysis of 20 years of chronobiologic studies (44% of them, accounting for 85% of total cases, with separate analysis by sex) confirmed that morning hours are a critical time of onset of acute cardiovascular diseases in men and women. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. A periodic density functional theory study of cumene formation catalyzed by H-mordenite.

    PubMed

    Rozanska, X; Barbosa, L A M M; van Santen, R A

    2005-02-17

    A periodic density functional theory study of the alkylation of benzene with propene in proton-exchanged mordenite has been achieved. The two different reaction routes that are usually proposed for this reaction, namely the direct and the step-by-step reaction pathways, have been investigated. The explicit consideration of the zeolite catalyst framework allows a better level of description of the interactions between the catalyst framework and the reaction than what is obtained with the cluster approach method. The direct reaction route is found to be the preferred one. It is observed that the cluster approach method, which does not describe the zeolite framework, is unable to qualitatively described the trend in activation energies. This is owing to the greater stabilization of larger transition state by the mordenite zeolite framework compared with smaller ones.

  15. Noise induced transitions and topological study of a periodically driven system

    NASA Astrophysics Data System (ADS)

    Chen, Zhen; Liu, Xianbin

    2017-07-01

    Noise induced transitions of an overdamped periodically driven oscillator are investigated theoretically and numerically in the limit of weak noise due to the Freidlin-Wentzell large deviation theory. Heteroclinic trajectories are found to approach the unstable orbit with fluctuational force tending to zeros. The global minimizer of the action functional corresponds to the most probable escape path and it shows a good agreement with statistical results. We then study the origins of singularities from a topological point of view by considering structures of the Lagrangian manifold and action surface. The switching line and cusp point turn out to have physical significance since they may impact the prehistory distributions, making the optimal path invalid.

  16. Feasibility study of a periodic arc compressor in the presence of coherent synchrotron radiation

    NASA Astrophysics Data System (ADS)

    Di Mitri, S.

    2016-01-01

    The advent of short electron bunches in high brightness linear accelerators has raised the awareness of the accelerator community to the degradation of the beam transverse emittance by coherent synchrotron radiation (CSR) emitted in magnetic bunch length compressors, transfer lines and turnaround arcs. Beam optics control has been proposed to mitigate that CSR effect. In this article, we enlarge on the existing literature by reviewing the validity of the linear optics approach in a periodic, achromatic arc compressor. We then study the dependence of the CSR-perturbed emittance to beam optics, mean energy, and bunch charge. The analytical findings are compared with particle tracking results. Practical considerations on CSR-induced energy loss and nonlinear particle dynamics are included. As a result, we identify the range of parameters that allows feasibility of an arc compressor for driving, for example, a free electron laser or a linear collider.

  17. Reference datasets for 2-treatment, 2-sequence, 2-period bioequivalence studies.

    PubMed

    Schütz, Helmut; Labes, Detlew; Fuglsang, Anders

    2014-11-01

    It is difficult to validate statistical software used to assess bioequivalence since very few datasets with known results are in the public domain, and the few that are published are of moderate size and balanced. The purpose of this paper is therefore to introduce reference datasets of varying complexity in terms of dataset size and characteristics (balance, range, outlier presence, residual error distribution) for 2-treatment, 2-period, 2-sequence bioequivalence studies and to report their point estimates and 90% confidence intervals which companies can use to validate their installations. The results for these datasets were calculated using the commercial packages EquivTest, Kinetica, SAS and WinNonlin, and the non-commercial package R. The results of three of these packages mostly agree, but imbalance between sequences seems to provoke questionable results with one package, which illustrates well the need for proper software validation.

  18. Die casting die deflections: Prediction and attenuation. Final report, July 1, 1995--September 30, 1997

    SciTech Connect

    Miller, R.Allen; Ahuett-Garza, Horacio; Choudhury, Aswin K.; Dedhia, Sanjay

    1998-05-01

    The objective of this work was to develop and test die casting design evaluation techniques based on the visualization of geometric data that is related to potential defects or problems. Specifically, thickness information is used to provide insight into potential thermal problems in the part and die. Distance from the gate and a special type of animation of the fill pattern is used to provide an assessment of gate, vent and overflow locations. Techniques have been developed to convert part design information in the form of STL files to a volume-based representation called a voxel model. The use of STL files makes the process CAD system independent. Once in voxel form, methods that were developed in this work are used to identify thick regions in the part, thin regions in the part and/or die, distance from user specified entry locations (gates), and the qualitative depiction of the fill pattern. The methods were tested with a prototype implementation on the UNIX platform. The results of comparisons with numerical simulation and field reported defects were surprisingly good. The fill-related methods were also compared against short-shots and a water analog study using high speed video. The report contains the results of the testing plus detailed background material on the construction of voxel models, the methods used for displaying results, and the computational geometric reasoning methods used to create die casting-related information from the voxel model for display to the user.

  19. A Study of the Utilization Patterns of an Elementary School-Based Health Clinic over a 5-Year Period

    ERIC Educational Resources Information Center

    Johnson, Veda; Hutcherson, Valerie

    2006-01-01

    The purpose of this study was to determine the utilization pattern of an elementary school-based clinic over a 5-year period. It involved a retrospective analysis of computer-based data for all patient visits during this study period. Results revealed high clinic utilization with an average of over 5 encounters for all users each year. The most…

  20. A Study of the Utilization Patterns of an Elementary School-Based Health Clinic over a 5-Year Period

    ERIC Educational Resources Information Center

    Johnson, Veda; Hutcherson, Valerie

    2006-01-01

    The purpose of this study was to determine the utilization pattern of an elementary school-based clinic over a 5-year period. It involved a retrospective analysis of computer-based data for all patient visits during this study period. Results revealed high clinic utilization with an average of over 5 encounters for all users each year. The most…