Rapport au Roi Souverain : rapport de la Commission d'Enquête ; A. M. le Secrétaire d'État de l'État Indépendant du Congo [31 octobre 1905]

Bakgrund: Den palliativa vården för hälso- och sjukvårdspersonal innebär att försöka uppnå den döende personens maximala livskvalitet och att lindra lidandet. Vården lutar sig mot det nationella vårdprogrammet för palliativ vård samt International Council of Nurses, ICN. Sjuksköterskans roll och uppgifter inom vården beskrivs där även de fyra hörnstenarna belyses. Syfte: Att belysa sjuksköterskornas upplevda svårigheter vid vård av patienter med palliativ diagnos. Metod: Examensarbetet är en litteraturöversikt baserad på Fribergs analysmetod. Denna litteraturöversikt inkluderar tio vetenskapliga artiklar som har sökts i databaserna CINAHL Complete och PubMed. Som en teoretisk utgångspunkt har Patricia Benners teori från novis till expert valts som en diskussion i resultatdiskussionen. Resultat: Sjuksköterskornas upplevda svårigheter av att vårda patienter med en palliativ diagnos resulterade i fyra huvudteman i litteraturöversikten; kommunikation, närstående och relation, vårdteamet samt kunskap och erfarenheter. Diskussion: Resultatet i litteraturöversikten har diskuterats utifrån Benners teori. Sjuksköterskornas upplevda svårigheter belystes genom fyra teman – kunskap och erfarenhet, närståendestöd, kommunikation mellan kollegor och gentemot patienten samt kultur som upplevd svårighet.Background: Palliative care for health professional means trying to achieve the maximum dying person's quality of life and ease suffering. The palliative care for health professionals means to try to achieve the dying person's maximum quality of life and alleviate suffering. The care inclined towards the Swedish national health care program for palliative care and the International Council of Nurses, ICN. The nurse's role and tasks in health care are described where even the four cornerstones elucidated. Aim: To elucidate the nurses perceived difficulties in nursing patients with palliative diagnosis. Method: The thesis is a literature review based on Friberg's analysis. This literature review includes ten scientific articles that have been searched in the databases CINAHL Complete and PubMed. As a theoretical base, Patricia Benner's theory from novice to expert was selected as a discussion of the results discussion. Results: The nurses perceived difficulties of caring for patients with a palliative diagnosis resulted in four main themes in the literature; communication, family and relationship, the health care team as well as knowledge and experience. Discussion: The results of the literature review are discussed based on Benner's theory. The nurses' perceived difficulties irradiated by four themes – knowledge and experience, family support, communication between colleagues and towards the patient as well the culture as perceived difficulties

Absorption lines from magnetically driven winds in X-ray binaries II: high resolution observational signatures expected from future X-ray observatories

In our self-similar, analytical, magneto-hydrodynamic (MHD) accretion-ejection solution, the density at the base of the outflow is explicitly dependent on the disk accretion rate - a unique property of this class of solutions. We had earlier found that the ejection index $p >\sim 0.1 (\dot{M}_{acc} \propto r^p )$ is a key MHD parameter that decides if the flow can cause absorption lines in the high resolution X-ray spectra of black hole binaries. Here we choose 3 dense warm solutions with $p = 0.1, 0.3, 0.45$ and carefully develop a methodology to generate spectra which are convolved with the Athena and XRISM response functions to predict what they will observe seeing through such MHD outflows. In this paper two other external parameters were varied - extent of the disk, $\rm{r_o|_{max}} = 10^5, \, 10^6 \,\, \rm{r_G}$, and the angle of the line of sight, $i \sim 10 - 25^{\circ}$. Resultant absorption lines (H and He-like Fe, Ca, Ar) change in strength and their profiles manifest varying degrees of asymmetry. We checked if a) the lines and ii) the line asymmetries are detected, in our suit of synthetic Athena and XRISM spectra. Our analysis shows that Athena should detect the lines and their asymmetries for a standard 100 ksec observation of a 100 mCrab source - lines with equivalent width as low as a few eV should be detected if the 6-8 keV counts are larger than $10^4 - 10^5$ even for the least favourable simulated cases.Comment: 18 pages, 13 figures in the main body and 3 figures in the appendix. Accepted for publication in MNRA

Yearly Incidence of Stroke and Bleeding in Atrial Fibrillation with Concomitant Hyperthyroidism: A National Discharge Database Study

Background: Hyperthyroidism is associated with atrial fibrillation (AF), and the latter is a major risk factor for stroke. Aim: We aimed to investigate the yearly incidence of stroke and bleeding in AF patients with and without concomitant hyperthyroidism from the French National Hospital Discharge Database. Methods: Admissions with AF between January 2010 and December 2019 were retrospectively identified and retrieved from the French national database. Incidence rates of ischaemic stroke and bleeding were compared in AF patients with and without concomitant hyperthyroidism. The associations of risk factors with ischaemic stroke were assessed by Cox regression. Results: Overall 2,421,087 AF patients, among whom 32,400 had concomitant hyperthyroidism were included in the study. During the follow-up (mean: 2.0 years, standard deviation SD: 2.2 years), the yearly incidence of ischaemic stroke was noted to be 2.6 (95% confidence interval CI: 2.5–2.8) in AF patients with concomitant hyperthyroidism, and 2.3 (95%CI: 2.3–2.4) in non-thyroid AF patients. Hyperthyroidism was noted as an independent risk factor for ischaemic stroke (adjusted hazard ratio aHR: 1.133, 95%CI: 1.080–1.189) overall, particularly within the first year of hyperthyroidism diagnosis (aHR 1.203, 95%CI 1.120–1.291), however, the association became non-significant in subsequent years (aHR 1.047, 95%CI 0.980–1.118). Major bleeding incidence was lower in the hyperthyroid AF group in comparison to the non-thyroid AF group (incidence ratio: 5.1 vs. 5.4%/year, p < 0.001). The predictive value of CHA(2)DS(2)VASc and HAS-BLED scores for ischaemic stroke and bleeding events, respectively, did not differ significantly between AF patients with or without concomitant hyperthyroidism. Conclusions: Hyperthyroidism seems to be an independent risk factor of ischaemic stroke in AF patients, particularly within the first year of hyperthyroidism diagnosis

The Maunakea Spectroscopic Explorer Book 2018

(Abridged) This is the Maunakea Spectroscopic Explorer 2018 book. It is intended as a concise reference guide to all aspects of the scientific and technical design of MSE, for the international astronomy and engineering communities, and related agencies. The current version is a status report of MSE's science goals and their practical implementation, following the System Conceptual Design Review, held in January 2018. MSE is a planned 10-m class, wide-field, optical and near-infrared facility, designed to enable transformative science, while filling a critical missing gap in the emerging international network of large-scale astronomical facilities. MSE is completely dedicated to multi-object spectroscopy of samples of between thousands and millions of astrophysical objects. It will lead the world in this arena, due to its unique design capabilities: it will boast a large (11.25 m) aperture and wide (1.52 sq. degree) field of view; it will have the capabilities to observe at a wide range of spectral resolutions, from R2500 to R40,000, with massive multiplexing (4332 spectra per exposure, with all spectral resolutions available at all times), and an on-target observing efficiency of more than 80%. MSE will unveil the composition and dynamics of the faint Universe and is designed to excel at precision studies of faint astrophysical phenomena. It will also provide critical follow-up for multi-wavelength imaging surveys, such as those of the Large Synoptic Survey Telescope, Gaia, Euclid, the Wide Field Infrared Survey Telescope, the Square Kilometre Array, and the Next Generation Very Large Array.Comment: 5 chapters, 160 pages, 107 figure

Multi-messenger observations of a binary neutron star merger

On 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of ~1.7 s with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg2 at a luminosity distance of 40+8-8 Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 Mo. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at ~40 Mpc) less than 11 hours after the merger by the One- Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ~10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position ~9 and ~16 days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta

Between but not within species variation in the distribution of fitness effects

New mutations provide the raw material for evolution and adaptation. The distribution of fitness effects (DFE) describes the spectrum of effects of new mutations that can occur along a genome, and is therefore of vital interest in evolutionary biology. Recent work has uncovered striking similarities in the DFE between closely related species, prompting us to ask whether there is variation in the DFE among populations of the same species, or among species with different degrees of divergence, i.e., whether there is variation in the DFE at different levels of evolution. Using exome capture data from six tree species sampled across Europe we characterised the DFE for multiple species, and for each species, multiple populations, and investigated the factors potentially influencing the DFE, such as demography, population divergence and genetic background. We find statistical support for there being variation in the DFE at the species level, even among relatively closely related species. However, we find very little difference at the population level, suggesting that differences in the DFE are primarily driven by deep features of species biology, and that evolutionarily recent events, such as demographic changes and local adaptation, have little impact

La romanisation des bouches du Danube (suite et fin) [2]

Seconde partie. Première partie :Gregoire, H. (1925). La romanisation des bouches du Danube [1]. Revue belge de philologie et d'histoire, 4, 317-331.info:eu-repo/semantics/publishe