Listening to parents: The role of symptom perception in pediatric palliative home care.

OBJECTIVE: This study analyzes symptom perception by parents and healthcare professionals and the quality of symptom management in a pediatric palliative home care setting and identifies which factors contribute to a high quality of palliative and end-of-life care for children. METHODS: In this retrospective, cross-sectional study, parents were surveyed at the earliest three months after their child's death. All children were cared for by a specialized home pediatric palliative care team that provides a 24/7 medical on-call service. Questionnaires assessed symptom prevalence and intensity during the child's last month of life as perceived by parents, symptom perception, and treatment by medical staff. The responses were correlated with essential palliative care outcome measures (e.g., satisfaction with the care provided, quality-of-life of affected children and parents, and peacefulness of the dying phase). RESULTS: Thirty-eight parent dyads participated (return rate 84%; 35% oncological disorders). According to parental report, dyspnea (61%) and pain (58%) were the dominant symptoms with an overall high symptom load (83%). Pain, agitation, and seizures could be treated more successfully than other symptoms. Successful symptom perception was achieved in most cases and predicted the quality of symptom treatment (R 2, 0.612). Concordant assessment of symptom severity between parents and healthcare professionals (HCPs) improved the satisfaction with the care provided (p = 0.037) as well as the parental quality-of-life (p = 0.041). Even in cases with unsuccessful symptom control, parents were very satisfied with the SHPPC team's care (median 10; numeric rating scale 0-10) and rated the child's death as highly peaceful (median 9). Significance of the results: The quality and the concordance of symptom perception between parents and HCPs essentially influence parental quality-of-life as well as parental satisfaction and constitute a predictive factor for the quality of symptom treatment and palliative care.

Automobile Corporate Networks in Europe : Sectoral Specialization of Central and Eastern European Cities

The global automobile industry is made up of very large corporations and their various subsidiaries containing different functions that create complex locational structures. The networks formed by the 19 largest automobile transnational corporations constitute an automobile "oligopoly" representing more than 90% (OICA, 2012) of the world's production. Since the mid-1990s, Central and Eastern European cities have become attractive for transnational corporations and particularly for the production functions in the automobile sector. This leads to a crucial question. Are strategic functions (such as R&D) within these networks also located in Central and Eastern Europe, or is the region still manufacturing-oriented in the automobile industry? This paper focuses on the patterns and the main factors influencing the role of some of these new central and Eastern European cities that have become integrated in the global value chain of the automobile industry. By analysing the various locations of the specialized functions within the corporations, this study aims to extend the research on global value chains (Gereffi and Korzeniewicz; 1994, Sturgeon, 2000; Krätke, 2014). The spatial patterns of the various functions and the ownerships networks of the automobile industry are constructed in order to identify the cities supporting it. In particular, the way that national metropolises bring their national territories into the globalization of the automobile industry is addressed. For example, are there some specific advantages of capital cities compared to cities that have less integration in globalization terms?

The role of advanced nursing in lung cancer: A framework based development.

PURPOSE: Advanced Practice Lung Cancer Nurses (APLCN) are well-established in several countries but their role has yet to be established in Switzerland. Developing an innovative nursing role requires a structured approach to guide successful implementation and to meet the overarching goal of improved nursing sensitive patient outcomes. The "Participatory, Evidence-based, Patient-focused process, for guiding the development, implementation, and evaluation of advanced practice nursing" (PEPPA framework) is one approach that was developed in the context of the Canadian health system. The purpose of this article is to describe the development of an APLCN model at a Swiss Academic Medical Center as part of a specialized Thoracic Cancer Center and to evaluate the applicability of PEPPA framework in this process. METHOD: In order to develop and implement the APLCN role, we applied the first seven phases of the PEPPA framework. RESULTS: This article spreads the applicability of the PEPPA framework for an APLCN development. This framework allowed us to i) identify key components of an APLCN model responsive to lung cancer patients' health needs, ii) identify role facilitators and barriers, iii) implement the APLCN role and iv) design a feasibility study of this new role. CONCLUSIONS: The PEPPA framework provides a structured process for implementing novel Advanced Practice Nursing roles in a local context, particularly where such roles are in their infancy. Two key points in the process include assessing patients' health needs and involving key stakeholders.

Does absorptive capacity determine collaborative research returns to innovation? A geographical dimension

This paper aims to estimate the impact of research collaboration with partners in different geographical areas on innovative performance. By using the Spanish Technological Innovation Panel, this study provides evidence that the benefits of research collaboration differ across different dimensions of the geography. We find that the impact of extra-European cooperation on innovation performance is larger than that of national and European cooperation, indicating that firms tend to benefit more from interaction with international partners as a way to access new technologies or specialized and novel knowledge that they are unable to find locally. We also find evidence of the positive role played by absorptive capacity, concluding that it implies a higher premium on the innovation returns to cooperation in the international case and mainly in the European one.

Where are women doing research in the field of ICTs?

Peer-reviewed

DFM(A)- aspects for a horn antenna design

In this paper aspects of design for manufacturability and assembly (DFMA) are applied to the design of coaxially fed standard gain horn antenna for 1.70 - 2.60 GHz. Possibilities to utilize cross-technological approach method is examined. Methods of DFMA for laser processing are covered and practical design guides and methods are developed. Antenna construction for easy manufacturing and specialized performance is shown. Required dimensions and tolerances are discussed and suitable materials for laser processing are selected.

The Pursuit of Efficient Copyright Licensing : How Some Rights Reserved Attempts to Solve the Problems of All Rights Reserved

This dissertation analyses the growing pool of copyrighted works, which are offered to the public using Creative Commons licensing. The study consist of analysis of the novel licensing system, the licensors, and the changes of the "all rights reserved" —paradigm of copyright law. Copyright law reserves all rights to the creator until seventy years have passed since her demise. Many claim that this endangers communal interests. Quite often the creators are willing to release some rights. This, however, is very difficult to do and needs help of specialized lawyers. The study finds that the innovative Creative Commons licensing scheme is well suited for low value - high volume licensing. It helps to reduce transaction costs on several le¬vels. However, CC licensing is not a "silver bullet". Privacy, moral rights, the problems of license interpretation and license compatibility with other open licenses and collecting societies remain unsolved. The study consists of seven chapters. The first chapter introduces the research topic and research questions. The second and third chapters inspect the Creative Commons licensing scheme's technical, economic and legal aspects. The fourth and fifth chapters examine the incentives of the licensors who use open licenses and describe certain open business models. The sixth chapter studies the role of collecting societies and whether two institutions, Creative Commons and collecting societies can coexist. The final chapter summarizes the findings. The dissertation contributes to the existing literature in several ways. There is a wide range of prior research on open source licensing. However, there is an urgent need for an extensive study of the Creative Commons licensing and its actual and potential impact on the creative ecosystem.

Defining a framework model to determine total costs of managed desktops using ITIL best practices

In modern day organizations there are an increasing number of IT devices such as computers, mobile phones and printers. These devices can be located and maintained by using specialized IT management applications. Costs related to a single device accumulate from various sources and are normally categorized as direct costs like hardware costs and indirect costs such as labor costs. These costs can be saved in a configuration management database and presented to users using web based development tools such as ASP.NET. The overall costs of IT devices during their lifecycle can be ten times higher than the actual purchase price of the product and ability to define and reduce these costs can save organizations noticeable amount of money. This Master’s Thesis introduces the research field of IT management and defines a custom framework model based on Information Technology Infrastructure Library (ITIL) best practices which is designed to be implemented as part of an existing IT management application for defining and presenting IT costs.

Palveluliiketoiminta teknologiateollisuudessa

Tutkimuksen tavoitteena on palveluliiketoimintaan liittyvien hypoteesien esittäminen ja niiden todentaminen case-yrityksen avulla. Differointistrategian merkitys ja sen tuomat mahdollisuudet teknologiateollisuuden palveluliiketoiminnassa ovat työn painopisteinä. Itse palveluliiketoimintaa todennettiin tutkimuksessa erinäisin kysymyksin. Tutkimuksen keskeiset aiheet ovat palveluliiketoiminta, differointistrategia, johon myös arvoketjuajattelu kuuluu vahvasti. Tutkimus on keskittynyt myös palveluliiketoiminnan tuottavuuteen ja kannattavuuteen. Jokaista asiaa on pyritty tarkastelemaan logistiikan näkökannalta, mistä on tehty tutkimuksen viitekehys. Tutkimus perustuu kirjallisuustutkimuksiin, havaintoihin ja haastatteluihin. Casetutkimuksen avulla pyritään todentamaan kirjallisuudesta esille tulleet asiat. Palveluliiketoiminta tarkoittaa lisäarvon tuottamista asiakkaalle. Differointistrategia on olennainen osa palveluliiketoimintaa. Differointistrategia perustuu erikoistumiseen ja ainutlaatuisuuteen. Logistiikan avulle voidaan tuottaa asiakkaalle räätälöityjä palveluja ja se mahdollistaa erikoistumisen, differoitumisen. Palveluliiketoiminnan edut ovat lisäarvon tuotto asiakkaalle joko lisäämällä asiakkaan myyntiä ja/tai luomalla kustannussäästöä. Palveluliiketoiminta vaatii toimittajalta strategian ja tavoitteiden muutosta, mutta ennen kaikkea asennemuutosta ja sitoutumista. Palvelun tuottavuus ja kannattavuus mittarit/näkökulmat tulee yrityksen yleensä muuttaa, sillä perinteiset mittaustavat eivät enää välttämättä sovi palveluliiketoiminnan toiminnan mittaamiseen.

Danza movimiento terapia y abuso sexual

L'organització mundial de la salut, assenyala que la major part de les agressions sexuals tenen com a víctimes a dones i nenes, i són perpetrades per homes i nens. En alguns països, gairebé una de cada quatre dones ha estat víctima de violència sexual per part de la seva parella i fins a una tercera part de les adolescents han sofert una iniciació sexual forçada. Estudis especialitzats fan referència al percentatge de dones que han sofert alguna forma d'abús sexual abans dels 18 anys. En el mateix sentit, enquestes mundials assenyalen que entre el 10% i el 69% de les dones diuen haver estat agredides físicament per una parella masculina en algun moment de la seva vida. La violència sexual infantil provoca a les seves víctimes una sèrie de repercussions i seqüeles, psicològiques, emocionals, socials; compromet el desenvolupament integral de l'individu, i provoca l'aparició d'una sèrie de patologies a l'edat adulta. La present investigació fa una revisió teòrica de la violència sexual, de la violència de gènere, i de les aportacions del procés de recuperació a través de la dansa moviment teràpia d'aquesta població. També es mostra el recorregut del marc d'actuació dels organismes d'ordre públic de la ciutat de Barcelona per a l'atenció i detecció en casos d'abús sexual

Estudo arqueométrico de cerâmicas do Sítio Guará, Goiás, Brasil

There is no evidence of urban civilization in Brazilian prehistory; most inhabitants lived in tribal groupings, probably with regional economic integration among several independent tribes. There is little evidence of seasonal migrations between the coast and the inland of southern Brazil. Some specialized horticulturists competed among themselves but other groups lived more isolated and probably peacefully, in the upper interfluvial regions. Chemical analysis of artifacts is a means of documenting traffic in particular materials and intraregional production and distribution, development of craft specialization and typological refinement among other issues. In this study we tested some possibilities in two different cultural contexts using the parametric k0 neutron activation analysis technique, which allowed the determination of elements: Al, As, Au, Ce, Cl, Co, Cr, Cs, Cu, Fe, Ga, K, La, Na, Rb, Sc, Ta, Ti, V and Zn.

Tendências evolutivas de famílias produtoras de cumarinas em angiospermae

Coumarins are special metabolites well distributed in the Angiospermae, either in Monocotyledoneae or Dicotyledoneae. Simple coumarins, the most widespread type, is found in all coumarin-producing families, such as: Apiaceae, Rutaceae, Asteraceae, Fabaceae, Oleaceae, Moraceae e Thymelaeaceae. The other types, linear- and angular furanocoumarins, linear- and angular pyranocoumarins, lignocoumarins, bis- and triscoumarins, are of more restricted circumscription. Among the families with occurrence numbers (NO) > 100, the more advanced ones are specialized in the production of only one or two coumarin types, while the primitive families are very well diversified in types. Calculations of percentual numbers of occurrence (%NO) show relevant meaning of coumarin-types in the taxonomic positioning of the producing taxa.

Kolmiulotteisen konenakojärjestelmän soveltuminen matkapuhelimen alikokoonpanojen testaukseen massatuotannossa

Tässä diplomityössä tutkitaan kolmiulotteisen konenak6järjestelmän soveltuvuutta matkapuhelimien alikokoonpanojen testaukseen massatuotannossa. Tavoitteena oli saada tietoa 3D järjestelmän käytettävyydestä suorituskyvyn ja kapasiteetin suhteen sekä selvittää järjestelmän joustavuutta testattavia tuotteita vaihdettaessa. Haluttiin myös selvittää, että ratkaiseeko 3D järjestelmä käytössä olevan 2D järjestelmän kanssa ilmenneitä ongelmia Järjestelmän suorituskykyä tutkittiin tekemällä testiajoja, joista saatuja tuloksia analysoitiin tilastollisella laadunvalvontaohjelmistolla. Varsinaisen kehitystyön teki konenäköjärjestelmiin erikoistunut alihankkija, jolla on kokemusta 3D testauksesta muilta teollisuuden aloilta. Matkapuhelimien alikokoonpanojen testauksessa laatukriteerit ja tarkkuusvaatimukset ovat kuitenkin liian kovia saavutettaviksi 3D lasertriangulaatioon perustuvaa testausjärjestelmää käytettäessä

Genome-wide analysis of adaptive molecular evolution in the carnivorous plant Utricularia gibba

The genome of the bladderwort Utricularia gibba provides an unparalleled opportunity to uncover the adaptive landscape of an aquatic carnivorous plant with unique phenotypic features such as absence of roots, development of water-filled suction bladders, and a highly ramified branching pattern. Despite its tiny size, the U. gibba genome accommodates approximately as many genes as other plant genomes. To examine the relationship between the compactness of its genome and gene turnover, we compared the U. gibba genome with that of four other eudicot species, defining a total of 17,324 gene families (orthogroups). These families were further classified as either 1) lineage-specific expanded/contracted or 2) stable in size. The U. gibba-expanded families are generically related to three main phenotypic features: 1) trap physiology, 2) key plant morphogenetic/developmental pathways, and 3) response to environmental stimuli, including adaptations to life in aquatic environments. Further scans for signatures of protein functional specialization permitted identification of seven candidate genes with amino acid changes putatively fixed by positive Darwinian selection in the U. gibba lineage. The Arabidopsis orthologs of these genes (AXR, UMAMIT41, IGS, TAR2, SOL1, DEG9, and DEG10) are involved in diverse plant biological functions potentially relevant for U. gibba phenotypic diversification, including 1) auxin metabolism and signal transduction, 2) flowering induction and floral meristem transition, 3) root development, and 4) peptidases. Taken together, our results suggest numerous candidate genes and gene families as interesting targets for further experimental confirmation of their functional and adaptive roles in the U. gibba's unique lifestyle and highly specialized body plan.

L'activitat quotidiana d'un mestre de cases medieval. Bernat Gual, 1405-1453

[cat] En aquest article es repassa l'activitat del mestre de cases Bernat Gual, des que va signar un contracte d'aprenentatge amb el mestre d'aixa Domingo Ferrer, l'any 1405, fi ns que desapareix de la documentació municipal, l'any 1453. En aquests quaranta-vuit anys d'activitat, Gual es va fer càrrec de grans obres (com ara l'assut de Xerta-Tivenys), però també d'una gran quantitat de petits treballs, sempre al servei del Consell de la Ciutat. La seva tasca s'emmarca en el context arquitectònic de la Tortosa medieval, determinat per la catedral i el palau del bisbe, però també pel Pont de Barques, una important infraestructura de fusta que era conservada per artesans especialitzats.