Volunteer policy in palliative care in Flanders : a content analysis of policy documents

Background: Volunteers are considered a third resource of palliative care (PC), next to family and professional caregivers, and can potentially increase the quality of patient care. Yet, conflicting expectations exist regarding volunteer roles, which may lead to role strain and attrition. Moreover, it is unclear how policy pertaining to volunteering within PC services addresses these issues. Therefore, volunteering policies of PC services in Flanders (Belgium) were analyzed, in terms of measures to combat role strain and how these vary across services. Methods: A full-population sample of services providing dedicated – PC units, day-care centers and home-care teams – or generalist PC – sitting services, community home-care, medical oncology departments and a random sample of nursing homes – were asked for their volunteer policy documents in 2016. Qualitative content analysis was performed using a coding frame comprising four main measures to combat role strain: leadership behavior, co-worker support, formalization and empowerment. Results: 264 (N=334; 79%) organizations responded to the survey. 67% claim to have and 45% sent in policy documents. Policy varies considerably, with measures mainly focused on formal aspects: role description, supervision, intervision, governance. Supportive measures such as training, recognition, autonomy, teamwork and emotional support are less accentuated. Dedicated PC services describe leadership behavior, co-worker support and empowerment more extensively and more often than generalist PC services. Conclusion: Given that best practices to tackle volunteer role strain are not widely integrated in organizational policy, their importance may not be acknowledged and their implementation in practice limited. Dedicated PC services appear to employ more role strain-reducing measures than generalist PC services. Further research is warranted to determine the exact impact of these policy measures on volunteer role strain and attrition. This study was funded by IWT SBO nr 140009

A Centerless Virasoro Algebra of Master Symmetries for the Ablowitz-Ladik Hierarchy

We show that the (semi-infinite) Ablowitz-Ladik (AL) hierarchy admits a centerless Virasoro algebra of master symmetries in the sense of Fuchssteiner [Progr. Theoret. Phys. 70 (1983), 1508-1522]. An explicit expression for these symmetries is given in terms of a slight generalization of the Cantero, Moral and Vel\'azquez (CMV) matrices [Linear Algebra Appl. 362 (2003), 29-56] and their action on the tau-functions of the hierarchy is described. The use of the CMV matrices turns out to be crucial for obtaining a Lax pair representation of the master symmetries. The AL hierarchy seems to be the first example of an integrable hierarchy which admits a full centerless Virasoro algebra of master symmetries, in contrast with the Toda lattice and Korteweg-de Vries hierarchies which possess only "half of" a Virasoro algebra of master symmetries, as explained in Adler and van Moerbeke [Duke Math. J. 80 (1995), 863-911], Damianou [Lett. Math. Phys. 20 (1990), 101-112] and Magri and Zubelli [Comm. Math. Phys. 141 (1991), 329-351]

Application of nuclear magnetic resonance spectroscopy for the detection of metabolic changes in blood cells with defective DNA repair

The DNA damage response (DDR) is a vast network of molecules that preserves genome integrity and allow the faithful transmission of genetic information in human cells. While the usual response to the detection of DNA lesions in cells involves the control of cell-cycle checkpoints, repair proteins or apoptosis, alterations of the repair processes can lead to cellular dysfunction, diseases, or cancer. Besides, cancer patients with DDR alterations often show poor survival and chemoresistance. Despite the progress made in recent years in identifying genes and proteins involved in DDR and their roles in cellular physiology and pathology, the question of the involvement of DDR in metabolism remains unclear. It remains to study the metabolites associated with specific repair pathways or alterations and to investigate whether differences exist depending on cellular origin. The identification of DDR-related metabolic pathways and of the pathways that cause metabolic reprogramming in DDR-deficient cells may produce new targets for the development of new therapies. In this thesis, nuclear magnetic resonance spectroscopy (NMR) was used to assess the metabolic consequence of the loss of two central DNA repair proteins with importance in diseases context, ATM and RNase H2, in haematological cells. An increase in intracellular taurine was found in RNase H2- and ATM-deficient cells compared to wild-type cells for these genes and in cells after exposition to a source of DNA damage. The rise in taurine does not appear to result from an increase in its biosynthesis from cysteine, but more likely from other cellular processes such as degradation pathways. Overall, evidence for metabolic reprogramming in haematological cells with faults in DNA repair resulting from ATM or RNase H2 deficiencies or upon exposition to a source of DNA damage is presented in this study

A centerless representation of the Virasoro algebra associated with the unitary circular ensemble

We consider the 2-dimensional Toda lattice tau functions $\tau_n(t,s;\eta,\theta)$ deforming the probabilities $\tau_n(\eta,\theta)$ that a randomly chosen matrix from the unitary group U(n), for the Haar measure, has no eigenvalues within an arc $(\eta,\theta)$ of the unit circle. We show that these tau functions satisfy a centerless Virasoro algebra of constraints, with a boundary part in the sense of Adler, Shiota and van Moerbeke. As an application, we obtain a new derivation of a differential equation due to Tracy and Widom, satisfied by these probabilities, linking it to the Painleve VI equation.Comment: 15 page

The liminal space palliative care volunteers occupy and their roles within it : a qualitative study

Objectives Volunteers have an important place in palliative care (PC), positively influencing quality of care for seriously ill people and those close to them and providing a link to the community. However, it is not well understood where volunteers fit into PC provision or how to support them adequately. We therefore chose to describe volunteer roles across care settings through the perspective of those closely involved in the care of terminally ill people. Methods A qualitative study was conducted using both focus groups with volunteers, nurses, psychologists and family physicians and individual semistructured interviews with patients and family caregivers. Participants were recruited from hospital, home, day care and live-in services. Results 79 people participated in the study. Two volunteer roles were identified. The first was 'being there' for the dying person. Volunteers represent a more approachable face of care, focused on psychological, social and existential care and building relationships. The second was the 'liaison' role. Volunteers occupy a liminal space between the professional and the family domain, through which they notice and communicate patient needs missed by other caregivers. Patient-volunteer matching was a facilitator for role performance; barriers were lack of communication opportunities with professional caregivers and lack of volunteer coordination. Conclusion Volunteers complement professional caregivers by (1) occupying a unique space between professionals, family and patients and fulfilling a liaison function and (2) being a unique face of care for patients. Healthcare services and policy can support volunteer role performance by ensuring frequent communication opportunities and volunteer coordination

Understanding the role and deployment of volunteers within specialist palliative care services and organisations as they have adjusted to the COVID-19 pandemic. A multi-national EAPC volunteer taskforce survey

Early indications were of a major decline in specialist palliative care volunteer numbers during COVID-19. It is important that ongoing deployment and role of volunteers is understood, given the dependence of many palliative care services on volunteers for quality care provision. To understand the roles and deployment of volunteers in specialist palliative care services as they have adjusted to the impact of COVID-19. Observational multi-national study, using a cross-sectional online survey with closed and free-text option questions. Disseminated via social media, palliative care networks and key collaborators from May to July 2021. Any specialist palliative care setting in any country, including hospices, day hospices, hospital based or community teams. The person responsible for managing the deployment of volunteers was invited to complete the survey. Valid responses were received from 304 organisations (35 countries, 80.3% Europe). Most cared for adults only (60.9%), provided in-patient care (62.2%) and were non-profit (62.5%). 47.0% had cared for people with COVID-19. 47.7% changed the way they deployed volunteers; the mean number of active volunteers dropped from 203 per organisation to 33, and 70.7% reported a decrease in volunteers in direct patient/family facing roles. There was a shift to younger volunteers. 50.6% said this drop impacted care provision, increasing staff workload and pressure, decreasing patient support, and increasing patient isolation and loneliness. The sustained reduction in volunteer deployment has impacted the provision of specialist palliative care. Urgent consideration must be given to the future of volunteering including virtual modes of delivery, micro-volunteering, and appealing to a younger demographic

Les nouvelles technologies et les nouveaux modes de financement : opportunités pour les ONG de coopération au développement?

Dans le contexte mondial actuel, les ONG (Organisations Non Gouvernementales) sont des acteurs incontournables dans le développement long terme de lutte contre la pauvreté et contre les inégalités entre les pays du Nord et du Sud (que nous appellerons « inégalités dans les pays du Sud »). Elles prennent alors la forme d’ONG de coopération au développement, ONGD. Grâce à leur capacité de mobilisation en personnel et en matériel, elles sont au centre des dispositifs d’aide au développement et d’assistance aux victimes, et elles sont un acteur de choix et digne de confiance vu leur indépendance, leur transparence et leurs valeurs. Pour la réalisation de leurs missions, leurs bailleurs de fonds publics et/ou privés jouent un rôle essentiel. Ce mémoire de fin d’étude a pour objectif d’appréhender leurs modes de financement avec les yeux d’un futur ingénieur de gestion et de voir en quoi les méthodes qui m’ont été enseignées ainsi que les nouvelles technologies et les nouveaux modes de financement peuvent ou non apporter des solutions à leurs difficultés de financement. Nombreuses sont les personnes qui partagent la conviction qu’innover dans la collecte de fonds est une nécessité pour les ONG. En effet, de nos jours, il est de plus en plus difficile de financer une cause exclusivement par l’appel aux fonds publics ou privés traditionnels. Lors de la première conférence internationale sur le financement du développement de Monterrey en 2002, un des objectifs majeurs était de faire contribuer les pays développés à verser 0,7% de leur Revenu National Brut (RNB) à l’aide publique au développement (APD) pour les pays en voie de développement d’ici 2015. A la veille de la troisième conférence internationale sur le financement du développement se déroulant en Ethiopie du 13 au 26 juillet 2015, on constate que beaucoup de pays (dont la Belgique) ne sont pas parvenus à atteindre cet objectif de 0,7% du RNB principalement suite aux crises économiques de ces dernières années, rendant l’apport public pour le développement incertain. De plus, on constate que certaines méthodes de récolte de fonds traditionnelles, soit arrivent à maturité et ne permettent plus d’attirer la générosité des donateurs aussi efficacement qu’auparavant, soit se sont fort professionnalisées rendant leur utilisation plus difficile pour certaines ONGD (notamment celles de plus petites tailles). D’où mon intérêt, à examiner les nouvelles alternatives que la technologie et l’innovation pourraient proposer au secteur de la coopération au développement pour récolter des fonds. Comme une entreprise, une ONG doit avoir une bonne gestion de ses campagnes de récoltes de fonds. Sensible à ce secteur, j’espère pouvoir de par ma formation en ingénieur de gestion, apporter par la même ma modeste contribution à de futurs projets, même si l’ampleur de la tâche est manifeste. Aujourd’hui, l’évolution des technologies ainsi que l’émergence d’une économie responsable et collaborative offrent aux ONG une opportunité de croissance unique dans le domaine de la collecte de fonds propres (fonds non subsidiés par les autorités). La créativité et l’innovation permettront-elles d’augmenter leurs moyens financiers en s’alliant par exemple au secteur marchand ? La question est posée. Après avoir précisé brièvement ce qu’est une organisation non gouvernementale (Partie I) et la forme juridique que la plupart ont dû opter en Belgique (ASBL) pour bénéficier de certains subsides, je rappelle quels sont les canaux de financement traditionnels des ONGD (Partie II) pour dresser ensuite une première liste des méthodes qui peuvent exister en matière de récolte de fonds ainsi que les défis de financement que les ONGD rencontrent aujourd’hui. La littérature classique sur les nouvelles technologies et les nouveaux modes de financement étant relativement limitée (et pour cause : le monde associatif est actuellement en pleine réflexion sur son modèle de financement par rapport aux nouveaux modes de collecte adoptés peu à peu par secteur marchand), j’ai décidé de procéder à plusieurs dizaines d’interviews d’ONG (dont une dizaine plus significatives sont annexées au présent mémoire – Annexe 3) dont certaines commencent peu à peu à aborder le marché des donateurs avec les mêmes méthodes que celles du monde marchand. Ce travail d’enquête m’a permis de mieux cerner les différentes méthodes de récolte décrites dans ma partie III (« La récolte de fonds ») mais aussi de rassembler les méthodes innovantes de récolte de fonds, de les expliquer et d’analyser leurs forces mais aussi leurs faiblesses (partie V) avant de répondre à la question posée dans le titre de mon mémoire : sont-elles des opportunités pour les ONG (conclusion)? Le recours aux méthodes modernes de récolte nécessitant une approche structurée, j’attire l’attention du lecteur sur le processus qui pourrait être mis en place par le secteur associatif pour améliorer la collecte de fonds et auquel souvent les organisations ne prêtent pas assez d’attention (partie IV).Master [120] en Ingénieur de gestion, Université catholique de Louvain, 201

Virasoro symmetries for the Ablowitz-Ladik hierarchy and non-intersecting Brownian motion models

Random matrix theory studies the distribution of the spectrum of matrices chosen randomly in various matrix ensembles. The link between random matrix theory and integrable systems has been exhibited in the 1980’s. This thesis is divided into two parts, both related to random matrix theory and integrable systems. The recurrent theme is the Virasoro algebra. The first part deals with the Ablowitz-Ladik (AL) hierarchy and the Circular Unitary Ensemble (CUE). The AL hierarchy is a hierarchy of compatible equations, of which the first one is the Ablowitz-Ladik equation, a space-discretization of the nonlinear cubic Schrödinger equation. The AL hierarchy comes up naturally when studying CUE, as the deformed gap probabilities of this ensemble are tau-functions for the AL hierarchy. We prove that the AL hierarchy admits a centerless Virasoro algebra of master symmetries. An explicit expression for these symmetries is given in terms of a generalisation of the Cantero-Moral-Velázquez matrices in the context of biorthogonal Laurent polynomials. Their action on the tau-functions of the hierarchy is described. The second part of this thesis deals with one-dimensional non-intersecting Brownian motions, starting from and going to several points. Of particular interest are the universal asymptotic processes which appear when the number of Brownian particles gets large. For one starting or ending point, the asymptotic processes are well understood. For several starting and ending points, some open problems remain. We study a finite number of non-intersecting Brownian motions starting from and going to an arbitrary number of points. The quantity of interest is the probability that at a given time all the Brownian particles are in a given set E, taken to be a union of intervals. We prove the existence of a partial differential equation satisfied by the log of this probability. The variables are the coordinates of the starting and ending points and the boundary points of the set E.(MATH 3) -- UCL, 201