58 resultados para Terminal vård

em Queensland University of Technology - ePrints Archive


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Background. There is considerable debate regarding the clinical issues surrounding the wish to hasten death (WTHD) in the terminally ill. The clinical factors contributing to the WTHD need further investigation among the terminally ill in order to enhance understanding of the clinical assessment and treatment needs that underlie this problem. A more detailed understanding may assist with the development of appropriate therapeutic interventions. Method. A sample of terminally ill cancer patients (N=256) recruited from an in-patient hospice unit, home palliative care service and a general hospital palliative care consulting service from Brisbane Australia between 1998–2001 completed a questionnaire assessing psychological (depression and anxiety), social (family relationship, social support, level of burden on others) and the impact of physical symptoms. The association between these factors and the WTHD was investigated. Results. A high WTHD was reported by 14% of patients. A discriminant function analysis revealed that the following variables were associated with a high WTHD (P<0·001): higher levels of depressive symptoms, being admitted to an in-patient hospice setting, a greater perception of being a burden on others, lower family cohesion, lower levels of social support, higher levels of anxiety and greater impact of physical symptoms. Conclusions. Psychological and social factors are related to a WTHD among terminally ill cancer patients. Greater attention needs to be paid to the assessment of psychological and social issues in order to provide appropriate therapeutic interventions for terminally ill patients.

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Improving the performance of a incident detection system was essential to minimize the effect of incidents. A new method of incident detection was brought forward in this paper based on an in-car terminal which consisted of GPS module, GSM module and control module as well as some optional parts such as airbag sensors, mobile phone positioning system (MPPS) module, etc. When a driver or vehicle discovered the freeway incident and initiated an alarm report the incident location information located by GPS, MPPS or both would be automatically send to a transport management center (TMC), then the TMC would confirm the accident with a closed-circuit television (CCTV) or other approaches. In this method, detection rate (DR), time to detect (TTD) and false alarm rate (FAR) were more important performance targets. Finally, some feasible means such as management mode, education mode and suitable accident confirming approaches had been put forward to improve these targets.

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This paper presents the design of self-tuning controllers for a two terminal HVDC link. The controllers are designed utilizing a novel discrete-time converter model based on multirate sampling. The nature of converter firing system necessitates the development of a two-step ahead self-tuning control strategy. A two terminal HVDC system study has been carried out to show the effectiveness of the control strategies proposed which include the design of minimum variance controller, pole assigned controller and PLQG controller. The coordinated control of a two terminal HVDC system has been established deriving the signal from inverter end current and voltage which has been estimated based on the measurements of rectifier end quantities only realized through the robust reduced order observer. A well known scaled down sample system data has been selected for studies and the controllers designed have been tested for worst conditions. The performance of self-tuning controllers has been evaluated through digital simulation.

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Flexibility is a key driver of any successful design, specifically in highly unpredictable environment such as airport terminal. Ever growing aviation industry requires airport terminals to be planned and constructed in such a way that will allow flexibility for future design, alteration and redevelopment. The concept of flexibility in terminal design is a relatively new initiative, where existing rules or guidelines are not adequate to assist designers. A shift towards flexible design concept would allow terminal buildings to be designed to accommodate future changes and to make passengers’ journey as simple, timely and hassle free as possible. Currently available research indicates that a theoretical framework on flexible design approach for airport terminals would facilitate the future design process. The generic principles of flexibility are investigated in the current research to incorporate flexible design approaches within the process of an airport terminal design. A conceptual framework is proposed herein, which is expected to ascertain flexibility to current passenger terminal facilities within their corresponding locations as well as in future design and expansion.

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In recent years, de-regulation in the airline industry and the introduction of low-cost carriers have conspired to produce significant changes in the airport landscape. From an airport operator’s perspective, one of the most notable has been the shift of capital revenue from traditional airline sources (through exclusive use, long term lease arrangements) to passengers (by way of fees collected from ticket sales). As a result of these developments, passengers have become recognized as major stakeholders who have the power to influence airport profitability. This link between passenger satisfaction and profitability has generated industry wide interest in the “passenger experience”. In this paper, we define the factors which influence passenger experience, namely (a) artifacts, (b) services and (c) the terminal building, and explore the challenges that exist in the current approaches to terminal design. On the basis of these insights, we propose a conceptual model of passenger experience, and motivate its use as a framework for further research into improving terminal design from a passenger oriented perspective.

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HIV-1 Pr55 Gag virus-like particles (VLPs) are strong immunogens with potential as candidate HIV vaccines. VLP immunogenicity can be broadened by making chimaeric Gag molecules: however, VLPs incorporating polypeptides longer than 200 aa fused in frame with Gag have not yet been reported. We constructed a range of gag-derived genes encoding in-frame C-terminal fusions of myristoylation-competent native Pr55Gag and p6-truncated Gag (Pr50Gag) to test the effects of polypeptide length and sequence on VLP formation and morphology, in an insect cell expression system. Fused sequences included a modified reverse transcriptase-Tat-Nef fusion polypeptide (RTTN, 778 aa), and truncated versions of RTTN ranging from 113 aa to 450 aa. Baculovirus-expressed chimaeric proteins were examined by western blot and electron microscopy. All chimaeras formed VLPs which could be purified by sucrose gradient centrifugation. VLP diameter increased with protein MW, from ∼100 nm for Pr55Gag to ∼250 nm for GagRTTN. The presence or absence of the Gag p6 region did not obviously affect VLP formation or appearance. GagRT chimaeric particles were successfully used in mice to boost T-cell responses to Gag and RT that were elicited by a DNA vaccine encoding a GagRTTN polypeptide, indicating the potential of such chimaeras to be used as candidate HIV vaccines. © 2008 Elsevier B.V. All rights reserved.

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Development of vaccine strategies against human papillomavirus (HPV), which causes cervical cancer, is a priority. We investigated the use of virus-like particles (VLPs) of the most prevalent type, HPV-16, as carriers of foreign proteins. Green fluorescent protein (GFP) was fused to the N or C terminus of both L1 and L2, with L2 chimeras being co-expressed with native L1. Purified chimaeric VLPs were comparable in size (∼55 nm) to native HPV VLPs. Conformation-specific monoclonal antibodies (Mabs) bound to the VLPs, thereby indicating that they possibly retain their antigenicity. In addition, all of the VLPs encapsidated DNA in the range of 6-8 kb. © 2007 Springer-Verlag.

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Flexible design concept is a relatively new trend in airport terminal design which is believed to facilitate the ever changing needs of a terminal. Current architectural design processes become more complex every day because of the introduction of new building technologies where the concept of flexible airport terminal would apparently make the design process even more complex. Previous studies have demonstrated that ever growing aviation industry requires airport terminals to be planned, designed and constructed in such a way that should allow flexibility in design process. In order to adopt the philosophy of ‘design for flexibility’ architects need to address a wide range of differing needs. An appropriate integration of the process models, prior to the airport terminal design process, is expected to uncover the relationships that exist between spatial layout and their corresponding functions. The current paper seeks to develop a way of sharing space adjacency related information obtained from the Business Process Models (BPM) to assist in defining flexible airport terminal layouts. Critical design parameters are briefly investigated at this stage of research whilst reviewing the available design alternatives and an evaluation framework is proposed in the current paper. Information obtained from various design layouts should assist in identifying and defining flexible design matrices allowing architects to interpret and to apply those throughout the lifecycle of the terminal building.

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The androgen receptor (AR) signaling pathway is a common therapeutic target for prostate cancer, because it is critical for the survival of both hormone-responsive and castrate-resistant tumor cells. Most of the detailed understanding that we have of AR transcriptional activation has been gained by studying classical target genes. For more than two decades, Kallikrein 3 (KLK3) (prostate-specific antigen) has been used as a prototypical AR target gene, because it is highly androgen responsive in prostate cancer cells. Three regions upstream of the KLK3 gene, including the distal enhancer, are known to contain consensus androgen-responsive elements required for AR-mediated transcriptional activation. Here, we show that KLK3 is one of a specific cluster of androgen-regulated genes at the centromeric end of the kallikrein locus with enhancers that evolved from the long terminal repeat (LTR) (LTR40a) of an endogenous retrovirus. Ligand-dependent recruitment of the AR to individual LTR-derived enhancers results in concurrent up-regulation of endogenous KLK2, KLK3, and KLKP1 expression in LNCaP prostate cancer cells. At the molecular level, a kallikrein-specific duplication within the LTR is required for maximal androgen responsiveness. Therefore, KLK3 represents a subset of target genes regulated by repetitive elements but is not typical of the whole spectrum of androgen-responsive transcripts. These data provide a novel and more detailed understanding of AR transcriptional activation and emphasize the importance of repetitive elements as functional regulatory units

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This paper examines the extent to which patients who have been diagnosed as having terminal cancer choose to use non-medical therapies. In particular it is concerned with the illness behaviour of patients who are receiving conventional cytotoxic drug and radiation treatments, who also decide to use a wide range of ‘alternative’ medications and therapies. The paper discusses the findings of a study of 152 patients with metastatic cancer that examined the extent to which they used alternative cancer therapies, as well as the beliefs and attitudes they have about their cancer, its treatment, and the practitioners providing that treatment. Four groups of users of alternative therapies, who differ according to their commitment to and the type of therapies they use, were identified. Results of logistic regression analyses indicate that those using alternative therapies were different in range of social attitudes. These differences were primarily their greater reported ‘will to live’ and desire for control over treatment decisions, and the differing beliefs they hold about their disease.