What are the components of humanized childbirth in a highly specialized hospital? : an organizational case study

Many studies have focused on the concept of humanization of birth in normal pregnancy cases or at low obstetric risk, but no studies, at our knowledge, have so far specifically focused on the humanization of birth in both high-risk, and low risk pregnancies, in a highly specialized hospital setting. The present study thus aims to: 1) define the specific components of the humanized birth care model which bring satisfaction to women who seek obstetrical care in highly specialized hospitals; and 2) explore the organizational and cultural dimensions which act as barriers or facilitators for the implementation of humanized birth care practices in a highly specialized, university affiliated hospital in Quebec. A single case study design was chosen for this thesis. The data were collected through semi-structured interviews, field notes, participant observations, selfadministered questionnaire, relevant documents, and archives. The samples comprised: 11 professionals from different disciplines, 6 administrators from different hierarchical levels within the hospital, and 157 women who had given birth at the hospital during the study. The performed analysis covered both quantitative descriptive and qualitative deductive and inductive content analyses. The thesis comprises three articles. In the first article, we proposed a conceptual framework, based on Allaire and Firsirotu’s (1984) organizational culture theory. It attempts to examine childbirth patterns as an organizational cultural phenomenon. In our second article, we answered the following specific question: according to the managers and multidisciplinary professionals practicing in a highly specialized hospital as well as the women seeking perinatal care in this hospital setting, what is the definition of humanized care? Analysis of the data collected uncovered the following themes which explained the perceptions of what humanized birth was: personalized care, recognition of women’s rights, humanly care for women, family-centered care,women’s advocacy and companionship, compromise of security, comfort and humanity, and non-stereotyped pregnancies. Both high and low risk women felt more satisfied with the care they received if they were provided with informed choices, were given the right to participate in the decision-making process and were surrounded by competent care providers. These care providers who humanly cared for them were also able to provide relevant medical intervention. The professionals and administrators’ perceptions of humanized birth, on the other hand, mostly focused on personalized and family-centered care. In the third article of the thesis, we covered the dimensions of the internal and external components of an institution which can act as factors that facilitate or barriers that prevent, a specialized and university affiliated hospital in Quebec from adopting a humanized child birthing care. The findings revealed that both the external dimensions of a highly specialized hospital -including its history, society, and contingency-; and its internal dimensions -including culture, structure, and the individuals present in the hospital-, can all affect the humanization of birth care in such an institution, whether separately, simultaneously or in interaction. We thus hereby conclude that the humanization of birth care in a highly specialized hospital setting, should aim to meet all the physiological, as well as psychological aspects of birth care, including respect of the fears, beliefs, values, and needs of women and their families. Integration of competent and caring professionals and the use of obstetric technology to enhance the level of certainty and assurance in both high-risk and low risk women are both positive factors for the implementation of humanized care in a highly specialized hospital. Finally, the humanization of birth care approach in a highly specialized and university affiliated hospital setting demands a new healthcare policy. Such policy must offer a guarantee for women to have the place of birth, and the health care professional of their choice as well as those, which will enable women to make informed choices from the beginning of their pregnancy.

Increased spinal pain sensitization : a new explanation for highly prevalent painful somatic symptoms in major depressive disorder?

Objectifs: Malgré que les patients souffrant de dépression majeure (DM) rapportent souvent des symptômes douloureux, la relation entre la douleur et la dépression n’est pas encore claire. Ce n’est que récemment que des études employant des paradigmes de sommation temporelle ont pu offrir une explication préliminaire de la cooccurrence de la douleur et de la dépression. Notre étude vise à évaluer la contribution des procédés spinaux et surpraspinaux dans la sensibilisation de la douleur dans la DM en utilisant un paradigme de sommation temporelle. Participants : Treize sujets sains et quatorze patients souffrant de DM ont été inclues dans l’analyse finale. Méthodes : Pour induire une sommation temporelle, nous avons utilisé des stimulations intermittentes du nerf sural de basses et hautes fréquences. La sensibilisation spinale de la douleur a été quantifiée en mesurant la variation de l’amplitude du réflex de retrait nociceptif (NFR) entre les deux conditions de stimulations, ainsi que la sensibilisation supraspinale de la douleur a été obtenue en mesurant le changement dans l’appréciation verbale de la douleur entre ces deux conditions. Résultats : Nous avons observé une sensibilisation plus élevée de la réponse NFR chez les patients dépressifs durant la condition de stimulation à haute fréquence, un effet qui n’a pas été reflété par une sensibilisation amplifiée des appréciations subjectives de la douleur durant l’expérience. Néanmoins, nous avons observé une association entre la sensibilisation spinale et les symptômes somatiques douloureux chez les patients DM. Conclusion : Ces résultats suggèrent une sensibilisation spinale amplifiée dans la DM, ce qui pourrait expliquer la prévalence élevée des symptômes somatiques douloureux chez ces patients.

First Example of Organocatalysis by Polystyrene-Supported PAMAM Dendrimers: Highly Efficient and Reusable Catalyst for Knoevenagel Condensations

This paper describes the first use of polystyrene-supported poly(amidoamine) (PAMAM) dendrimers as heterogeneous basic organocatalysts for carbon–carbon bond formation. Polystyrene-supported PAMAM dendrimers of first, second and third generations have been used as reusable base catalysts in Knoevenagel condensations of carbonyl compounds with active methylene compounds. The reactions proceed in short periods of time and with 100% selectivity. This novel catalyst eliminates the use of aromatic and halogenated solvents, as well as complex purification processes. The catalysts can be recycled ten times.

Mercuric Chloride Catalysed Solvolysis of Benzyl Chloride in Water & Highly Aqueous Organic Solvent Systems

Kinetics of mercuric chloride catalysed solvolysis of benzyl chloride have been studied in water. 10% aq. ethanol, 10,20 and 30% aq. acetone and 20% aq. DMSO. The results confirm the operation of a mass law effect.

Highly conductive and transparent ZnO thin film using Chemical Spray Pyrolysis technique: Effect of doping and deposition parameters

In the present work we report the preparation details studies on ZnO thin films. ZnO thin films are prepared using cost effective deposition technique viz., Chemical Spray Pyrolysis (CSP). The method is very effective for large area preparation of the ZnO thin film. A new post-deposition process could also be developed to avoid the adsorption of oxygen that usually occurs after the spraying process i.e., while cooling. Studies were done by changing the various deposition parameters for optimizing the properties of ZnO thin film. Moreover, different methods of doping using various elements are also tried to enhance the conductivity and transparency of the film to make these suitable for various optoelectronic applications.

Studies On Developing A Facile Route For The Synthesis Of Highly Substituted Quinoline And Indole Derivatives

the thesis entitled “STUDIES ON DEVELOPING A FACILE ROUTE FOR THE SYNTHESIS OF HIGHLY SUBSTITUTED QUINOLINE AND INDOLE DERIVATIVES” portrays our attempt to revisit the mechanism of 1,3- dipolar additions with a view to establishing whether it follows a concerted pathway or a stepwise reaction sequence through the formation of a zwitterionic intermediate, which will definitely contribute to the better use of this technique. Furthermore, we propose to develop novel routes for the synthesis of quinoline and indole derivatives with predefined substitution pattern. The thesis is devided into four chapters

A facile strategy for the synthesis of highly substituted imidazole using tetrabutyl ammoniumbromide as catalyst

A simple and facile strategy for the synthesis of highly substituted imidazoles has been developed by multi-component condensation of 1,2-diketone, aldehyde, amine, and ammonium acetate in presence of tetrabutyl ammonium bromide as catalyst

A Novel Acinetobacter Sp. For 'Treating Highly Acidic Rubber Latex Cen'trifugation Effluent

A novel Acinetobacter sp. BTJR-IO isolated from highly acidic (pH 2.5-4.5) rubber latex centrifugation effluent with high COD (22000 rng/L) and BOD (5000 rng/L). This strain could effect 39.5% COD reduction on free cell inoculation of effluent without incorporation of additional nutrients after 8 days. CalciLnn alginate irrmobilized cells showed 16.4% and 25% COD reduction after 6 hra, without aeration and after 1 hr. with mild aeration under batch process respectively. Whereas 44.0% COD reduction could be achieved after 6 hrs. on continuous treatment in a packed bed reactor with mild aeration. Further, even after 3 cycles 37% COD reduction was recorded with continuous treatment

Structural And Surface Morphological Investigation Of Formation Stages Of Highly (002) Oriented Zno Films On Glass Substrates By Spray Pyrolysis Method

ZnO thin films were coated on amorphous glass substrate at various temperatures in the range 160-500 0C by spray pyrolysis method. The as deposited films were characterised by using XRD and SEM. Wurtzite phase of ZnO was formed at a substrate temperature of 400 0C, highly oriented (002) phase was developed with respect to increase of substrate temperature from 450 to 500 0C. Morphological and growth mode of these films were analyzed with respect to structural orientation of films from wurtzite to highly (002) oriented phase. Present study reveals that substrate temperature was one of the important parameters which determine the crystalline quality, population of defects, grain size, orientation and morphology of the films

Polarization and correlation phenomena in the radiative electron capture by bare highly-charged ions

In dieser Arbeit wird die Wechselwirkung zwischen einem Photon und einem Elektron im starken Coulombfeld eines Atomkerns am Beispiel des radiativen Elektroneneinfangs beim Stoß hochgeladener Teilchen untersucht. In den letzten Jahren wurde dieser Ladungsaustauschprozess insbesondere für relativistische Ion–Atom–Stöße sowohl experimentell als auch theoretisch ausführlich erforscht. In Zentrum standen dabei haupsächlich die totalen und differentiellen Wirkungsquerschnitte. In neuerer Zeit werden vermehrt Spin– und Polarisationseffekte sowie Korrelationseffekte bei diesen Stoßprozessen diskutiert. Man erwartet, dass diese sehr empfindlich auf relativistische Effekte im Stoß reagieren und man deshalb eine hervorragende Methode zu deren Bestimmung erhält. Darüber hinaus könnten diese Messungen auch indirekt dazu führen, dass man die Polarisation des Ionenstrahls bestimmen kann. Damit würden sich neue experimentelle Möglichkeiten sowohl in der Atom– als auch der Kernphysik ergeben. In dieser Dissertation werden zunächst diese ersten Untersuchungen zu den Spin–, Polarisations– und Korrelationseffekten systematisch zusammengefasst. Die Dichtematrixtheorie liefert hierzu die geeignete Methode. Mit dieser Methode werden dann die allgemeinen Gleichungen für die Zweistufen–Rekombination hergeleitet. In diesem Prozess wird ein Elektron zunächst radiativ in einen angeregten Zustand eingefangen, der dann im zweiten Schritt unter Emission des zweiten (charakteristischen) Photons in den Grundzustand übergeht. Diese Gleichungen können natürlich auf beliebige Mehrstufen– sowie Einstufen–Prozesse erweitert werden. Im direkten Elektroneneinfang in den Grundzustand wurde die ”lineare” Polarisation der Rekombinationsphotonen untersucht. Es wurde gezeigt, dass man damit eine Möglichkeit zur Bestimmung der Polarisation der Teilchen im Eingangskanal des Schwerionenstoßes hat. Rechnungen zur Rekombination bei nackten U92+ Projektilen zeigen z. B., dass die Spinpolarisation der einfallenden Elektronen zu einer Drehung der linearen Polarisation der emittierten Photonen aus der Streuebene heraus führt. Diese Polarisationdrehung kann mit neu entwickelten orts– und polarisationsempfindlichen Festkörperdetektoren gemessen werden. Damit erhält man eine Methode zur Messung der Polarisation der einfallenden Elektronen und des Ionenstrahls. Die K–Schalen–Rekombination ist ein einfaches Beispiel eines Ein–Stufen–Prozesses. Das am besten bekannte Beispiel der Zwei–Stufen–Rekombination ist der Elektroneneinfang in den 2p3/2–Zustand des nackten Ions und anschließendem Lyman–1–Zerfall (2p3/2 ! 1s1/2). Im Rahmen der Dichte–Matrix–Theorie wurden sowohl die Winkelverteilung als auch die lineare Polarisation der charakteristischen Photonen untersucht. Beide (messbaren) Größen werden beträchtlich durch die Interferenz des E1–Kanals (elektrischer Dipol) mit dem viel schwächeren M2–Kanal (magnetischer Quadrupol) beeinflusst. Für die Winkelverteilung des Lyman–1 Zerfalls im Wasserstoff–ähnlichen Uran führt diese E1–M2–Mischung zu einem 30%–Effekt. Die Berücksichtigung dieser Interferenz behebt die bisher vorhandene Diskrepanz von Theorie und Experiment beim Alignment des 2p3/2–Zustands. Neben diesen Ein–Teichen–Querschnitten (Messung des Einfangphotons oder des charakteristischen Photons) wurde auch die Korrelation zwischen den beiden berechnet. Diese Korrelationen sollten in X–X–Koinzidenz–Messungen beobbachtbar sein. Der Schwerpunkt dieser Untersuchungen lag bei der Photon–Photon–Winkelkorrelation, die experimentell am einfachsten zu messen ist. In dieser Arbeit wurden ausführliche Berechnungen der koinzidenten X–X–Winkelverteilungen beim Elektroneneinfang in den 2p3/2–Zustand des nackten Uranions und beim anschließenden Lyman–1–Übergang durchgeführt. Wie bereits erwähnt, hängt die Winkelverteilung des charakteristischen Photons nicht nur vom Winkel des Rekombinationsphotons, sondern auch stark von der Spin–Polarisation der einfallenden Teilchen ab. Damit eröffnet sich eine zweite Möglichkeit zur Messung der Polaristion des einfallenden Ionenstrahls bzw. der einfallenden Elektronen.

Calculation of the electronic properties of neutral and ionized divalent-metal clusters

The electronic properties of neutral and ionized divalent-metal clusters have been studied using a microscopic theory, which takes into account the interplay between van der Waals (vdW) and covalent bonding in the neutral clusters, and the competition between hole delocalization and polarization energy in the ionized clusters. By calculating the ground-state energies of neutral and ionized. Hg_n clusters, we determine the size dependence of the bond character and the ionization potential I_p(n). For neutral Hg_n clusters we obtain a transition from van del Waals to covalent behaviour at the critical size n_c ~ 10-20 atoms. Results for I_p(Hg_n) with n \le 20 are in good agreement with experiments, and suggest that small Hg_n^+ clusters can be viewed as consisting of a positive trimer core Hg_3^+ surrounded by n - 3 polarized neutral atoms.

Thermodynamic functions of element 105 in neutral and ionized states

The basic thermodynamic functions, the entropy, free energy, and enthalpy, for element 105 (hahnium) in electronic configurations d^3 s^2, d^3 sp, and d^4s^1 and for its +5 ionized state (5f^14) have been calculated as a function of temperature. The data are based on the results of the calculations of the corresponding electronic states of element 105 using the multiconfiguration Dirac-Fock method.

Time-resolved studies of neutral and ionized Na_n clusters with femtosecond light pulses

The real-time dynamics of Na_n (n=3-21) cluster multiphoton ionization and fragmentation has been studied in beam experiments applying femtosecond pump-probe techniques in combination with ion and electron spectroscopy. Three dimensional wave packet motions in the trimer Na_3 ground state X and excited state B have been observed. We report the first study of cluster properties (energy, bandwidth and lifetime of intermediate resonances Na_n^*) with femtosecond laser pulses. The observation of four absorption resonances for the cluster Na_8 with different energy widths and different decay patterns is more difficult to interpret by surface plasmon like resonances than by molecular structure and dynamics. Timeresolved fragmentation of cluster ions Na_n^+ indicates that direct photo-induced fragmentation processes are more important at short times than the statistical unimolecular decay.

Analytical Study of Light Propagation in Highly Nonlinear Media

The present dissertation is devoted to the construction of exact and approximate analytical solutions of the problem of light propagation in highly nonlinear media. It is demonstrated that for many experimental conditions, the problem can be studied under the geometrical optics approximation with a sufficient accuracy. Based on the renormalization group symmetry analysis, exact analytical solutions of the eikonal equations with a higher order refractive index are constructed. A new analytical approach to the construction of approximate solutions is suggested. Based on it, approximate solutions for various boundary conditions, nonlinear refractive indices and dimensions are constructed. Exact analytical expressions for the nonlinear self-focusing positions are deduced. On the basis of the obtained solutions a general rule for the single filament intensity is derived; it is demonstrated that the scaling law (the functional dependence of the self-focusing position on the peak beam intensity) is defined by a form of the nonlinear refractive index but not the beam shape at the boundary. Comparisons of the obtained solutions with results of experiments and numerical simulations are discussed.

Highly Sensitive Sensor Based On Intracavity Laser Absorption Spectroscopy By Means of Relative Intensity Noise

This thesis concerns with the main aspects of medical trace molecules detection by means of intracavity laser absorption spectroscopy (ICLAS), namely with the equirements for highly sensitive, highly selective, low price, and compact size sensor. A novel two modes semiconductor laser sensor is demonstrated. Its operation principle is based on the competition between these two modes. The sensor sensitivity is improved when the sample is placed inside the two modes laser cavity, and the competition between the two modes exists. The effects of the mode competition in ICLAS are discussed theoretically and experimentally. The sensor selectivity is enhanced using external cavity diode laser (ECDL) configuration, where the tuning range only depends on the external cavity configuration. In order to considerably reduce the sensor cost, relative intensity noise (RIN) is chosen for monitoring the intensity ratio of the two modes. RIN is found to be an excellent indicator for the two modes intensity ratio variations which strongly supports the sensor methodology. On the other hand, it has been found that, wavelength tuning has no effect on the RIN spectrum which is very beneficial for the proposed detection principle. In order to use the sensor for medical applications, the absorption line of an anesthetic sample, propofol, is measured. Propofol has been dissolved in various solvents. RIN has been chosen to monitor the sensor response. From the measured spectra, the sensor sensitivity enhancement factor is found to be of the order of 10^(3) times of the conventional laser spectroscopy.