12 resultados para end state comfort
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Data are reported demonstrating the potential role of microscale morphologies, induced by endolithic lichen communities, specifically Verrucaria baldensis, in the initiation and development of mesoscale solution basin formation on limestone in the Burren, Co. Clare. A biophysical model is proposed outlining the different microscale stages leading to solution basin initiation with a progression from initial lichen colonisation and growth, associated biopitting followed by biopit coalescence to form biotroughs, their subsequent enlargement and eventual incipient solution basin formation. This model provides one explanation for solution basin development as this end state may also be achieved through simple solutional means without biological input. The complexity of interactions at the rock / lichen interface are identified with emphasis on the spatial and temporal variability of these underlining the point that, as with macro-topographies at the landscape scale, rock surface micro-topographies also reflect historical weathering legacies.
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Performed by Shiau-uen Ding. Composer's Voice Concert Series: 15 Minutes of Fame. Jan Hus Church, NYC.
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We demonstrate that perfect state transfer can be achieved using an engineered spin chain and clean local end-chain operations, without requiring the initialization of the state of the medium nor fine-tuning of control pulses. This considerably relaxes the prerequisites for obtaining reliable transfer of quantum information across interacting-spin systems. Moreover, it allows us to shed light on the interplay among purity, entanglement, and operations on a class of many-body systems potentially useful for quantum information processing tasks.
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New elements associated withWeb 2.0 relating to interactivity and end-user focus have combined with the availability of newlevels of information to encourage the development of what may be termed a Gov 2.0 approach.This, in combination with recent initiatives in the modernising government programme, has emphasised new levels of public participation and engagement with government as well as a re-engineering of public services tomake them more responsive to their end users. Adopting a governmentality perspective, it is argued that this involves a wider process of governing through constructing and reconstructing ideas of the public, community and individual citizen-consumers who take on a role in their own governance. It is argued that this fundamental re-working of the nature of what is public represents a constitutional change that is perhaps more signi¢cant than the constitutional reform programme directed to formal government which attracts more attention
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Facilitating moral insight in end of life care can be challenging, and the purpose of this paper is to illustrate how this can be nurtured by means of creative literature. Tolstoy's Death of Ivan Ilych is presented as an example of such literature. Aristotle's Nichomean Ethics provides the philosophical underpinning for the method used. Sources also include the nursing literature, and students' evaluations of the impact of Tolstoy's novella on their ability to perceive the ethical issues arising in end of life care. Comments from evaluations were analysed and significant themes emerged. Students' comments clearly support the suggestion that use of this novella has facilitated insight into ethical issues at the end of life. Evaluations also indicate that vicarious experience gained through reading this novella has helped to nurture sensitivity and professional insight into the importance of compassion and offering ‘comfort’ to the dying person.
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The study examined the utility of the Family Perception of Care Scale (FPCS), which consists of four subscales: resident care, family support, communication, and rooming. This instrument was developed for the purposes of this study. Overall, family members were satisfied with end-of-life care. Satisfaction did not have a statistically significant relationship to family and resident characteristics. Survey questions with the highest number of low satisfaction ratings included staffing levels, updating families and involving them in care planning, and decision making. Family members considered pain control an important priority, followed by comfort care that included caring for a family member with dignity and sensitivity. Family members also valued it when staff were able to inform them that the death of their family member was near. Place of death was significantly associated with satisfaction, family members being more satisfied with end-of-life care when their family member died in the LTC facility as opposed to in hospital.
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Background: Families of patients with advanced dementia need to be informed about the course of the dementia and comfort care. Conditional for health care providers educating families is their knowledge and comfort in family education. Methods: Perceived usefulness and acceptability of a Canadian family booklet explaining possible complications and comfort care in dementia was assessed by physicians and nurses caring for dementia patients in 14 nursing homes in Lombardy, Italy and 21 in the Netherlands. The practitioners received a questionnaire and translated versions adapted to local practice where needed. In 10 of 21 Dutch homes, physicians evaluated only the original Canadian version in English. A 15-item scale assessed the booklet's acceptability, for example, to inform families, or for educational purposes. Perceived usefulness referred to proportion of families of dementia patients for whom the booklet would be useful. A total of 168 evaluations were available for multivariable regression analyses. Results: The practitioners anticipated that the booklet would be useful for most families. Evaluation of the Dutch translation of the booklet was similar to the English version. Country (Netherlands) and profession (nurses) were independently associated with better acceptability. Usefulness was perceived as better by Italian respondents and nurses, but only in analyses unadjusted for the higher educational needs of these respondents. Conclusion: Overall, the concept of written information on comfort care was appreciated by practitioners of European countries differing in attitudes toward end-of-life care. A booklet may help practitioners, and in particular nurses, in providing comfort care for dementia patients and their families. © Copyright 2011, Mary Ann Liebert, Inc. 2011.
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Background: The families of people with late-stage dementia need to be informed about the course of the dementia and the comfort/ palliative care option. A booklet was written for that purpose and can be provided to family members by physicians and nurses. Methods: The acceptability of the booklet for nurses was tested in Canada (French and English version), France (French Canadian version) and Japan (translated and adapted version). Results: Overall, 188 nurses completed a survey questionnaire. The booklet was accepted best in Canada and less so in France and Japan. Despite regional variation, the majority of the nurses perceived the booklet as useful for families. The French and Japanese nurses also reported a greater need for palliative care education in advanced dementia. Conclusion: The booklet may help nurses educate families about end-of-life issues in dementia palliative care, but local adaptation of the booklet content and physician engagement are necessary.
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Two recent scanning probe techniques were applied to investigate the bipolar twin state of 4-iodo-4'-nitrobiphenyl (INBP) crystals. Solution grown crystals of INBP show typically a morphology which does not express that of a mono-domain polar structure (Fdd2, mm2). From previous X-ray diffraction a twinning volume ratio of similar to 70 : 30 is now explained by two unipolar domains (Flack parameter: 0.075(29)) of opposite orientation of the molecular dipoles, joined by a transition zone showing a width of similar to 140 mm. Scanning pyroelectric microscopy (SPEM) demonstrates a continuous transition of the polarization P from +P into -P across the zone. Application of piezoelectric force microscopy (PFM) confirms unipolar alignment of INBP molecules down to a resolution of similar to 20 nm. A previously proposed real structure for INBP crystals built from lamellae with antiparallel alignment is thus rejected. Anomalous X-ray scattering was used to determine the absolute molecular orientation in the two domains. End faces of the polar axis 2 are thus made up by NO2 groups. Using a previously determined negative pyroelectric coefficient pc leads to a confirmation also by a SPEM analysis. Calculated values for functional group interactions (D...A), (A...A), (D...D) and the stochastic theory of polarity formation allow us to predict that NO2 groups should terminate corresponding faces. Following the present analysis, INBP may represent a first example undergoing dipole reversal upon growth to end up in a bipolar state.
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This article reports a pilot evaluation of Comfort Care Rounds (CCRs)-a strategy for addressing long-term care home staff's palliative and end-of-life care educational and support needs. Using a qualitative descriptive design, semistructured individual and focus group interviews were conducted to understand staff members' perspectives and feedback on the implementation and application of CCRs. Study participants identified that effective advertising, interest, and assigning staff to attend CCRs facilitated their participation. The key barriers to their attendance included difficulty in balancing heavy workloads and scheduling logistics. Interprofessional team member representation was sought but was not consistent. Study participants recognized the benefits of attending; however, they provided feedback on how the scheduling, content, and focus could be improved. Overall, study participants found CCRs to be beneficial to their palliative and end-of-life care knowledge, practice, and confidence. However, they identified barriers and recommendations, which warrant ongoing evaluation.
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The Field Programmable Gate Array (FPGA) implementation of the commonly used Histogram of Oriented Gradients (HOG) algorithm is explored. The HOG algorithm is employed to extract features for object detection. A key focus has been to explore the use of a new FPGA-based processor which has been targeted at image processing. The paper gives details of the mapping and scheduling factors that influence the performance and the stages that were undertaken to allow the algorithm to be deployed on FPGA hardware, whilst taking into account the specific IPPro architecture features. We show that multi-core IPPro performance can exceed that of against state-of-the-art FPGA designs by up to 3.2 times with reduced design and implementation effort and increased flexibility all on a low cost, Zynq programmable system.