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To study the dendritic morphology of retinal ganglion cells in wild-type mice we intracellularly injected these cells with Lucifer yellow in an in vitro preparation of the retina. Subsequently, quantified values of dendritic thickness, number of branching points and level of stratification of 73 Lucifer yellow-filled ganglion cells were analyzed by statistical methods, resulting in a classification into 9 groups. The variables dendritic thickness, number of branching points per cell and level of stratification were independent of each other. Number of branching points and level of stratification were independent of eccentricity, whereas dendritic thickness was positively dependent (r = 0.37) on it. The frequency distribution of dendritic thickness tended to be multimodal, indicating the presence of at least two cell populations composed of neurons with dendritic diameters either smaller or larger than 1.8 µm ("thin" or "thick" dendrites, respectively). Three cells (4.5%) were bistratified, having thick dendrites, and the others (95.5%) were monostratified. Using k-means cluster analysis, monostratified cells with either thin or thick dendrites were further subdivided according to level of stratification and number of branching points: cells with thin dendrites were divided into 2 groups with outer stratification (0-40%) and 2 groups with inner (50-100%) stratification, whereas cells with thick dendrites were divided into one group with outer and 3 groups with inner stratification. We postulate, that one group of cells with thin dendrites resembles cat ß-cells, whereas one group of cells with thick dendrites includes cells that resemble cat a-cells.

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Cholangiocarcinomas (CCs) are malignant tumors that originate from epithelial cells lining the biliary tree and gallbladder. Ras correlative C3 creotoxin substrate 1 (Rac1), a small guanosine triphosphatase, is a critical mediator of various aspects of endothelial cell functions. The objective of the present investigation was to study the effect of blocking Rac1 expression in CCs. Seventy-four extrahepatic CC (ECC) specimens and matched adjacent normal mucosa were obtained from the Department of Pathology, Inner Mongolia Medicine Hospital, between 2007 and 2009. Our results showed that the expression of Rac1 was significantly higher (53.12%) in tumor tissues than in normal tissues. Western blotting data indicated a significant reduction in Rac1-miRNA cell protein levels. Rac1-miRNA cell growth rate was significantly different at 24, 48, and 72 h after transfection. Flow cytometry analysis showed that Rac1-miRNA cells undergo apoptosis more effectively than control QBC939 cells. Blocking Rac1 expression by RNAi effectively inhibits the growth of CCs. miRNA silencing of the Rac1 gene suppresses proliferation and induces apoptosis of QBC939 cells. These results suggest that Rac1 may be a new gene therapy target for CC. Blocking Rac1 expression in CC cells induces apoptosis of these tumor cells and may thus represent a new therapeutic approach.

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Few studies have reported the molecular epidemiological characterization of HIV-1 in the Northern region of Brazil. The present study reports the molecular and epidemiological characterization of 31 HIV-1 isolates from blood donors from the State of Amazonas who donated blood between April 2006 and March 2007. Serum/plasma samples from all donors were screened for HIV antibodies by ELISA and the results confirmed by Western blot analysis. Genomic DNA was extracted from the buffy coat using the Super Quik-Gene-DNA Isolation kit. Nested PCR was performed on the env, gag, and pol regions of HIV-1 using the Gene Amp PCR System 9700. Sequencing reactions were performed using the inner PCR primers and the DYEnamic™ ET Dye Terminator Kit, and phylogenetic analysis was performed using the gag, pol, and env gene sequences. We collected samples from 31 blood donors who tested positive for HIV-1 in confirmatory experiments. The male:female ratio of blood donors was 3.4:1, and the mean age was 32.4 years (range: 19 to 61 years). Phylogenetic analysis showed that subtype B is the most prevalent among Northern Brazilian HIV-1-seropositive blood donors. One HIV-1 subtype C and one circulating recombinant form (CRF_BF) of HIV-1 were identified in the State of Amazonas. This is the first study showing the occurrence of a possible "homogenous" subtype C in this region of Brazil. This finding could contribute to a better characterization of the HIV-1 strains that circulate in the country.

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During gonad and adrenal development, the POD-1/capsulin/TCF21transcription factor negatively regulates SF-1/NR5A1expression, with higher SF-1 levels being associated with increased adrenal cell proliferation and tumorigenesis. In adrenocortical tumor cells, POD-1 binds to the SF-1 E-box promoter region, decreasing SF-1 expression. However, the modulation of SF-1 expression by POD-1 has not previously been described in normal adrenal cells. Here, we analyzed the basal expression of Pod-1 and Sf-1 in primary cultures of glomerulosa (G) and fasciculata/reticularis (F/R) cells isolated from male Sprague-Dawley rats, and investigated whether POD-1 overexpression modulates the expression of endogenous Sf-1 and its target genes in these cells. POD-1 overexpression, following the transfection of pCMVMycPod-1, significantly decreased the endogenous levels of Sf-1 mRNA and protein in F/R cells, but not in G cells, and also decreased the expression of the SF-1 target StAR in F/R cells. In G cells overexpressing POD-1, no modulation of the expression of SF-1 targets, StAR and CYP11B2, was observed. Our data showing that G and F/R cells respond differently to ectopic POD-1 expression emphasize the functional differences between the outer and inner zones of the adrenal cortex, and support the hypothesis that SF-1 is regulated by POD-1/Tcf21 in normal adrenocortical cells lacking the alterations in cellular physiology found in tumor cells.

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The aim of the study and research questions: The aim of this study is to illuminate how caring communion can aid in promoting health as becoming in elderly people in the context of natural caring. The target group of the study consists of elderly citizens living at home. The focus of this thesis is on the concept of communion and how caring communion can affect the inner health resources in a patient’s inner health domain, as well as how caring communion can support health as becoming and inner health resources in the elderly. The main research questions of this study are the following: 1) what does communion mean? 2) what does caring communion mean? 3) what is the connection between caring communion and health? Theoretical perspective: The theoretical perspective of this qualitative study relies on the caritative caring theory as developed by scholars of caring sciences at the Åbo Academi University’s Vasa unit. The caritas motive is based on an ethos built on a consideration of togetherness, i.e. caring communion, a place where one feels at home and where one can be the person one was meant to be. Methodology: A hermeneutic research approach based on Gadamer (1997) permeates the study. This entails that understanding and interpretation become central. The study conducted in the thesis is divided into three sub-studies. Sub-study one and two are based on ontological determination whereas the third sub-study is carried out by contextual determination. The first sub-study is conducted by etymological and semantic analysis of the concept of communion (gemenskap) based on Koort (1975) and the second sub-study by determining the basic epistemological category of the concept based on Eriksson (2010b). Sub-study three is conducted through content analysis of 18 multidisciplinary and 13 caring science articles and dissertations based on Kvale (2009). The aim in the third sub-study is to define caring communions in various contexts of meaning based on Eriksson´s model of conceptual determination (2010b). All studies are interpreted through hermeneutic interpretation where the continuous movement from a part of a whole, to the whole, to part again, leads to new understanding. Finally, the findings from all the three sub-studies are compared to the concepts of pre-understanding and the inner-health-domain model of Wärnås (2002). Results: The results of the study offer a description of the dimensions of caring communion and a model that illuminates how caring communion can further health as becoming. The fundamentals of caring communion rest on the idea of a human being’s absolute right to dignity as a base for communion. The concept of communion contains a moral, an ethical, and a spiritual component. In communion, there exists a moral and ethical responsibility and a willingness to commit oneself. The individual is part of a connection or relation and knows the aim and course for the communion. A caring connection, a caring culture, a caring atmosphere and caring listening are characteristics of caring communion. In caring communion, the elderly feel trusting and see themselves as unique, powerful, and valuable. The model demonstrates that when the elderly are able to rest in caring communion, the virtues of courage and faith become strong and desire for life awaken within the elderly and health as becoming becomes possible. Conclusions: The outcome of the study is that all communion is not necessarily caring communion. In order for communion to be caring and for the elderly to achieve health as becoming, there are certain criteria that must be met. This is especially important when designing activities for the elderly in the context of natural caring.

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The purpose of this project was to evaluate the sanitization effect on the quality of minimally processed guava. Initially, research was carried out with consumers in a supermarket to verify preferences of packaging for guava. Following this, the guava cv. Paluma underwent two sanitization sequences using dehydrated sodium dichloroisocyanurate compound, in 50 ppm concentration, sanitization prior to (S1) and after (S2) being cut; removal of excess water; conditioning in PET packaging and PSPVC and storage at 3 ºC ± 1 ºC. Physicochemical analysis - [pH, total soluble solids (SST), total labeled acidity (ATT), ascorbic acid (AA), total sugars (AT) and reducers (AR)], textural sensorial and microbiological analyses were used to monitor the quality of the products. The consumers preferred the guava cut in halves with pulp and packed in PET, although this packaging promoted condensation of water vapor on the inner surface of the lid, compromising the appearance of the product. The two sanitization sequences and the two kinds of packaging did not significantly affect the pH, SST, ATT, SST/ATT, texture and AA values. The AT and AR tenors increased significantly in the MP guavas stored in the PSPVC package. Both sanitizations were efficient in the bacterial control of the indicators of the hygienicsanitary conditions, although the S1 sanitization proved to be more efficient in the control of autochthonous aerobic microbiota (aerobic mesophylic microorganisms). It can be concluded that guava cv. Paluma packed in PSPVC can be conserved for 6 days when stored at 3 ºC.

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Artemia salina bioassay was used to assess toxicity of seeds and kernels of Brazilian fruits from cerrado (central high plains region) and other inner regions of the country. Water extracts of the kernels were filtered and added to Artemia cultures containing ten individuals per mL. Dose - response curves were constructed, and LD50 values were calculated. Pure potassium cyanide standard was used to draw a calibration curve for comparison to detect the presence of cyanide in the samples tested. Extracts of the seeds of araticum, mangaba, cagaita, jatobá, and tucumã were found toxic to Artemia salina, and some of the dose - response curves were very similar in shape to those obtained with pure potassium cyanide standards, while the samples of baru, cajá-manga, siriguela, trauma, and veludo showed no toxicity at all. The Guignard test, specific for cyanide detection, showed negative results in all toxic samples, suggesting the presence of other toxic compounds rather than cyanide. The comparison of araticum dose - response curve with those of other annonaceous fruits suggests the presence acetogenins as the main toxic compounds in the seeds. These results could be useful to prevent poisoning by industrial derivatives of the fruits studied.

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The increasing use of energy, food, and materials by the growing population in the world is leading to the situation where alternative solutions from renewable carbon resources are sought after. The growing use of plastics depends on the raw-oil production while oil refining are politically governed and required for the polymer manufacturing is not sustainable in terms of carbon footprint. The amount of packaging is also increasing. Packaging is not only utilising cardboard and paper, but also plastics. The synthetic petroleum-derived plastics and inner-coatings in food packaging can be substituted with polymeric material from the renewable resources. The trees in Finnish forests constitute a huge resource, which ought to be utilised more effectively than it is today. One underutilised component of the forests is the wood-derived hemicelluloses, although Spruce Oacetyl-galactoglucomannans (GGMs) have previously shown high potential for material applications and can be recovered in large scale. Hemicelluloses are hydrophilic in their native state, which restrains the use of them for food packaging as non-dry item. To cope with this challenge, we intended to make GGMs more hydrophobic or amphiphilic by chemical grafting and consequently with the focus of using them for barrier applications. Methods of esterification with anhydrides and cationic etherification with a trimethyl ammonium moiety were established. A method of controlled synthesis to obtain the desired properties by the means of altering temperature, reaction time, the quantity of the reagent, and even the solvent for purification of the products was developed. Numerous analytical tools, such as NMR, FTIR, SEC-MALLS/RI, MALDI-TOF-MS, RP-HPLC and polyelectrolyte titration were used to evaluate the products from different perspectives and to acquire parallel proofs of their chemical structure. Modified GGMs with different degree of substitution and the correlating level of hydrophobicity was applied as coatings on cartonboard and on nanofibrillated cellulose-GGM films to exhibit barrier functionality. The water dispersibility in processing was maintained with GGM esters with low DS. The use of chemically functionalised GGM was evaluated for the use as barriers against water, oxygen and grease for the food packaging purposes. The results show undoubtedly that GGM derivatives exhibit high potential to function as a barrier material in food packaging.

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Viestinnän merkitys yritysten menestymisessä on huomattu viimeisten vuosikymmenien aikana ja myös yritysten sisäiseen viestintään kiinnitetään yhä enemmän huomiota. Tutkimukset ovat osoittaneet, että suurin osa organisaatioissa esiintyneistä ongelmista johtuu epäonnistuneesta viestinnästä. Suurin osa kirjallisuudesta keskittyy tarkastelemaan sisäistä viestintää yleisellä tasolla, ottamatta kantaa tarkemmin erilaisten organisaatioiden erityispiirteisiin. Tämän työn tarkoituksen on tarkastella sisäistä viestintää tuotanto-organisaation kontekstissa. Työn tarkoituksena oli tutkia vanerituotantolaitoksen sisäisen viestinnän tilaa ja viestinnän suunnittelua strategisella sekä käytännön tasolla. Työn tuloksena päivitettiin tehtaan sisäinen viestintästrategia tehtaan henkilökunnalle tehdyn kvantitatiivisen tutkimuksen, sekä aikaisempien tutkimusten perusteella. Lisäksi aihetta lähestyttiin havainnoimalla konkreettisia sisäisen viestinnän parantamisen keinoja kolmessa muussa tuotanto-organisaatiossa. Työn tuloksena saatiin arvokasta tietoa tehtaan sisäisen viestinnän tasosta ja kehitysideoita sisäisen viestinnän kehittämiseen. Kyselytutkimuksen tulokset myös tukivat aikaisempien tutkimuksien tuloksia viestinnän tärkeistä elementeistä.

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Höyryvoimalaitoksen käyttöönotossa muodostuu kattilaputkien sisäpinnoille niitä korroosiolta suojaava ohut metallioksidikerros. Tämän kerroksen päälle kasvaa kattilan käytön aikana haitallista kerrostumaa paikallisen korroosion tai kattilavedessä olevien epäpuhtauksien kerääntymisen tai kiteytymisen seurauksena. Kerrostuma haittaa lämmönsiirtoa tulipesästä putkiseinämän läpi kattilaveteen. Putkien lämpötilan nousu suunniteltua korkeammaksi kasvattaa putkivaurioiden ja sisäpuolisen korroosion riskiä. Tästä johtuen paksuksi kasvaneet kerrostumat pyritään poistamaan happokäsittelyllä eli peittauksella ennen vaurioiden syntyä. Perinteisesti kerrostumapaksuus on määritetty kattilasta irrotetuista näyteputkista mikroskoopilla. Työn tavoitteena oli tutkia uudenlaisen ultraäänimittauksen teoriaa ja selvittää sen toimivuus höyrystinputkien kerrostumapaksuusmittauksissa. Lisäksi tavoitteena oli tutkia voimalaitoksen höyrystimen sisäpuolisten kerrostumien muodostumista ja niiden vaikutuksia sekä kattilan peittaustarpeen arviointia. Höyrystimen kerrostumien kasvunopeuteen vaikuttavat eniten voimalaitostyyppi, käytetty vesikemia ja kattilaveteen kulkeutuvien epäpuhtauksien määrä. Kasvunopeus vaihtelee laitosten välillä suuresti ja eroaa myös tulipesän eri kohdissa. Kattilaveden epäpuhtauspitoisuus ja kerrostumapaksuus vaikuttavat molemmat korroosiovaurioiden todennäköisyyteen. Peittauspaksuuden ohjearvoissa tulisi huomioida kattilan käyttöpaine, kattilatyyppi ja riski kattilaveden laadun heikkenemiselle. Putkinäytteistä ja laitoksilla suoritettujen mittauksien perusteella uusi ultraäänitekniikka tuottaa luotettavia tuloksia tavanomaisten kerrostumien mittauksessa. Vain yhdellä laitoksella esiintyi irtonaisen sakan kaltaista kerrostumaa, jota mittaus ei kyennyt havaitsemaan. Mittaustulokset kerrostumista tulipesän eri osissa antavat hyvän perustan peittaustarpeen arviointiin.

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Hemicelluloses are potential raw material for several items produced in future wood-based biorefineries. One possible method for recovering hemicelluloses from wood extracts is ultrafiltration (UF). However, low filtration capacities and severe fouling restrict the use of tight UF membranes in the treatment of wood extracts. The lack of suitable commercial membranes creates a need for pretreatment which would decrease fouling and increase the filtration capacity. This thesis focuses on the evaluation of the possibility to improve the filtration capacity and decrease fouling with the pretreatment of wood extracts. Methods which remove harmful compounds and methods which degrade them are studied, as well as combinations of the methods. The tested pretreatments have an influence on both the concentration of different compounds and the molecular mass distribution of the compounds in the extract. This study revealed that in addition to which kind of compounds were removed, also the change in molecular size distribution affected the filtration capacity significantly. It was shown that the most harmful compounds for the filtration capacity of the hydrophobic 5 kDa membrane were the ones capable of permeating the membrane and fouling also the inner membrane structure. Naturally, the size of the most harmful compounds depends on the used UF membrane and is thus case-specific. However, in the choice of the pretreatment method, the focus should be on the removal of harmful compound sizes rather than merely on the total amount of removed foulants. The results proved that filtration capacity can be increased with both adsorptive and oxidative pretreatments even by hundreds of per cents. For instance, the use of XAD7 and XAD16 adsorbents increased the average flux in the UF of a birch extract from nearly zero to 107 kg/(m2h) and 175 kg/(m2h), respectively. In the treatment of a spruce extract, oxidation by pulsed corona discharge (PCD) increased the flux in UF from 46 kg/(m2h) to 158 kg/(m2h). Moreover, when a birch extract batch was treated with laccase enzyme, the flux in UF increased from 15 kg/(m2h) to 36 kg/(m2h). However, fouling was decreased only by adsorptive pretreatment while oxidative methods had a negligible or even negative impact on it. This demonstrates that filtration capacity and fouling are affected by different compounds and mechanisms. The results of this thesis show that filtration capacity can be improved and fouling decreased through appropriate pretreatment. However, the choice of the best possible pretreatment is case-specific and depends on the wood extract and the membrane used. Finding the best option requires information on the extract content and membrane characteristics as well as on the filtration performance of the membrane in the prevailing conditions and a multivariate approach. On the basis of this study, it can be roughly concluded that adsorptive pretreatment improves the filtration capacity and decreases fouling rather reliably, but it may lead to significant hemicellulose losses. Oxidation reduces the loss of valuable hemicelluloses and could improve the filtration capacity, but fouling challenges may remain. Combining oxidation with adsorptive pretreatment was not a solution for avoiding hemicellulose losses in the tested cases.

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Intelligence from a human source, that is falsely thought to be true, is potentially more harmful than a total lack of it. The veracity assessment of the gathered intelligence is one of the most important phases of the intelligence process. Lie detection and veracity assessment methods have been studied widely but a comprehensive analysis of these methods’ applicability is lacking. There are some problems related to the efficacy of lie detection and veracity assessment. According to a conventional belief an almighty lie detection method, that is almost 100% accurate and suitable for any social encounter, exists. However, scientific studies have shown that this is not the case, and popular approaches are often over simplified. The main research question of this study was: What is the applicability of veracity assessment methods, which are reliable and are based on scientific proof, in terms of the following criteria? o Accuracy, i.e. probability of detecting deception successfully o Ease of Use, i.e. easiness to apply the method correctly o Time Required to apply the method reliably o No Need for Special Equipment o Unobtrusiveness of the method In order to get an answer to the main research question, the following supporting research questions were answered first: What kinds of interviewing and interrogation techniques exist and how could they be used in the intelligence interview context, what kinds of lie detection and veracity assessment methods exist that are reliable and are based on scientific proof and what kind of uncertainty and other limitations are included in these methods? Two major databases, Google Scholar and Science Direct, were used to search and collect existing topic related studies and other papers. After the search phase, the understanding of the existing lie detection and veracity assessment methods was established through a meta-analysis. Multi Criteria Analysis utilizing Analytic Hierarchy Process was conducted to compare scientifically valid lie detection and veracity assessment methods in terms of the assessment criteria. In addition, a field study was arranged to get a firsthand experience of the applicability of different lie detection and veracity assessment methods. The Studied Features of Discourse and the Studied Features of Nonverbal Communication gained the highest ranking in overall applicability. They were assessed to be the easiest and fastest to apply, and to have required temporal and contextual sensitivity. The Plausibility and Inner Logic of the Statement, the Method for Assessing the Credibility of Evidence and the Criteria Based Content Analysis were also found to be useful, but with some limitations. The Discourse Analysis and the Polygraph were assessed to be the least applicable. Results from the field study support these findings. However, it was also discovered that the most applicable methods are not entirely troublefree either. In addition, this study highlighted that three channels of information, Content, Discourse and Nonverbal Communication, can be subjected to veracity assessment methods that are scientifically defensible. There is at least one reliable and applicable veracity assessment method for each of the three channels. All of the methods require disciplined application and a scientific working approach. There are no quick gains if high accuracy and reliability is desired. Since most of the current lie detection studies are concentrated around a scenario, where roughly half of the assessed people are totally truthful and the other half are liars who present a well prepared cover story, it is proposed that in future studies lie detection and veracity assessment methods are tested against partially truthful human sources. This kind of test setup would highlight new challenges and opportunities for the use of existing and widely studied lie detection methods, as well as for the modern ones that are still under development.

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It is well known that Kant’s aesthetics is framed intersubjectively because he upholds the claim of taste to universality. However, the transcendental foundation of this shared universality is a supersensible ground which is taken for granted but which cannot be brought directly into communicative experience. Kant’s reliance on the synthetic a priori structure of aesthetic judgment also removes it from the sphere of observable personal interaction. This argumentative strategy exposes it to skeptical challenge and generates inaccessible references to inner representations (be they intuitions, categories of the understanding or rational ideas). It is not sufficient, as Kant did, to propose a description of aesthetic experience that is subjectively plausible and thereby claim its intersubjective validity. It is indispensable to embody intersubjectivity in behavior and language. In practical intersubjectivity, aesthetic attitudes are dealt with in a concrete and accessible manner without relying on mentalistic assumptions as a foundation. Conceptual terms such as 'agreeable’, 'beauty’, 'sublime’, 'ugly’, 'universality’ acquire new meaning in a conversational context and aesthetic claims are tested in a dialogical game semantics model.

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Tämän kandidaatintutkielman tarkoituksena oli selvittää minkälaisia liiketoiminnallisia mahdollisuuksia ja haasteita Big Dataan ja sen ominaispiirteisiin liittyy, ja miten Big Data määritellään nykyaikaisesti ja ajankohtaisesti. Tutkimusongelmaa lähestyttiin narratiivisen kirjallisuuskatsauksen keinoin. Toisin sanoen tutkielma on hajanaisen tiedon avulla koostettu yhtenäinen katsaus nykytilanteeseen. Lähdeaineisto koostuu pääosin tieteellisistä artikkeleista, mutta käytössä oli myös oppikirjamateriaalia, konferenssijulkaisuja ja uutisartikkeleja. Tutkimuksessa käytetyt akateemisen kirjallisuuden lähteet sisälsivät keskenään paljon samankaltaisia näkemyksiä tutkimusaihetta kohtaan. Niiden perusteella muodostettiin kaksi taulukkoa havaituista mahdollisuuksista ja haasteista, ja taulukoiden rivit nimettiin niitä kuvaavien ominaispiirteiden mukaan. Tutkimuksessa liiketoiminnalliset mahdollisuudet ja haasteet jaettiin viiteen pääkategoriaan ja neljään alakategoriaan. Tutkimus toteutettiin liiketoiminnan näkökulmasta, joten siinä sivuutettiin monenlaisia Big Datan teknisiä aspekteja. Tutkielman luonne on poikkitieteellinen, ja sen avulla pyritään havainnoimaan tämän hetken yhtä uusinta tietojenkäsittelykäsittelytieteiden termiä liiketoiminnallisessa kontekstissa. Tutkielmassa Big Dataan liittyvillä ominaispiirteillä todettiin olevan mahdollisuuksia, jotka voitiin jaotella korrelaatioiden havaitsemisen perusteella markkinoiden tarkemman segmentoinnin mahdollisuuksiin ja päätöksenteon tukena toimimiseen. Reaaliaikaisen seurannan mahdollisuudet perustuvat Big Datan nopeuteen ja kokoon, eli sen jatkuvaan kasvuun. Ominaispiirteisiin liittyvät haasteet voidaan jakaa viiteen kategoriaan, joista osa liittyy toimintaympäristöön ja osa organisaation sisäiseen toimintaan.

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The overall aim of the study is to create a theory model of “becoming” as a human being and health care provider in the caring communion at the end-of-life. The theoretical perspective of the study is caring science as it is developed at Åbo Academy University in Finland outlined in Eriksson's theory of caritative caring with focus on caring ethics. The thesis consists of four sub-studies reported as scientific articles and a summary section. The study has an overarching hermeneutic research approach. The sub-studies I-IV are reinterpreted from viewpoint of the overall question. Empirical assumptions could then be discerned from the substance of the four substudies, which raised questions. The answers to these questions were sought in dialogue with selected texts by Kierkegaard and resulted in a theory model. The theory model results in following theses: 1. To “become” as a human being is to remain in an endless guilt. Guilt is a form of love. It is guilt that give strength and willingness to act in love and mercy when caring for patients at the end-of-life. The guilt as love allows becoming as a human being to be at home in love and mercy. 2. The human being’s courage is characterized as the willingness to obtain contact with the life of fellow human beings. This courage develops over time to stand for itself, with a foundation of belief in human beings, and resulting in a selfless, loving way to help the patients grieve and reconcile at the end-of-life. 3. To be “touched” can be illustrated as an inner awakening; an inner movement towards consciousness for the examination of the love for one another, and to love unselfishly. 4. The human being’s evolution in its own understanding of life occurs in the care of another human being who is at the end-of-life, as well as to be at home in ethos, love and mercy. Becoming in this context means that the human being evolves to become responsive to the heart's inner voice; an inner strength and joy which opens to the eternal and holy. 5. To overcome external obstacles is characterized as serving human beings in a selfless love; a caring in love that has requirements that need to be expressed by what is true, beautiful and good for patients at the end-of-life. An awareness and understanding of what it means to become as a human being and health care provider in caring community can help health care providers to easily focus on the patient.