Deep-seated barriers to end-of-life-care improvement in the twenty-first century

No abstract available

Evolution and change in palliative care around the world

Palliative care developed in the later part of the 20th century as a social movement and medical speciality. Central to its modern development were the ideas of Dr Cicely Saunders, whose vision for improving the care of the dying encompassed the physical, psychological, social and spiritual domains while emphasizing the importance of rigorous clinical practice, training and research. St Christopher’s Hospice, which she founded, inspired generations of practitioners and influenced the expansion of hospices nationally and internationally. Terminal care evolved into the discipline of palliative care, which applied holistic principles to the care of those earlier in their disease trajectory and in different settings, such as hospitals and the community. Some countries now have national strategies for palliative care that are supported by government. Palliative care attracts increasing attention as an aspect of the public health system and there are calls for access to it to be recognized as a human right. Yet around the world, palliative care is not uniformly developed and it needs to press hard to secure full integration with prevailing health policies. Palliative care still reaches only a tiny proportion of those who could benefit from it, especially those with diseases other than cancer. The global challenge for palliative care in the 21st century is to develop models and coverage appropriate to those in need, whatever their diagnosis, income or setti

Polymer dynamics studied by dynamic light scattering : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Physics at Massey University

Appendix 1 and 2 – articles have been removed due to copyright. The articles are available in the print copy held in the library.Theoretical treatments of dynamic properties of polymer solutions are reviewed. Particular emphasis is placed on the discussion of diffusion in polymer solutions. The relationship between the slow diffusion coefficient found by Dynamic Light Scattering (DLS) and the Self Diffusion Coefficient is shown. An introduction to DLS theory is given. The experimental techniques involved in DLS measurements are discussed. Concentration dependencies of the DLS observed slow diffusion coefficient in ternary polymer solutions of polystyrene-poly vinyl methyl ether-solvent have been measured. Solvents used were toluene, carbon tetrachloride and tetrachloroethylene and the polymer molar masses were 110 000 gmol -1 for both polystyrene (PS) and poly vinyl methyl ether (PVME). Solvents were chosen to be very nearly isorefractive with PVME. Toluene is very nearly an equally good solvent for the polymer pair PS and PVME, while tetrachloroethylene is equally poor for both polymers. Carbon tetrachloride is an unequal quality solvent for this polymer pair. The results of these DLS measurements are reported. Four sets of experiments are described. The first is the effect on the relationship between D 1 (the slow mode diffusion coefficient found by DLS) and D s (the self diffusion coefficient) of different mass fractions in the polymer solution. It is found the mass fraction, x, has little effect on the observed diffusion coefficient. Secondly the effect of the polymer-polymer interaction parameter, x, on the relationship between D 1 and D s is investigated. It is found solutions formed with equal quality solvents have D 1 nearly equal to D s . But solutions formed with unequal quality solvents have D 1 considerably less than D s and that these solutions suffer phase separation at lower concentration. Thirdly the effect of polymer molar mass on the relationship between D 1 and D s is investigated. These are found to be in line with those expected from literature. Fourthly the considerable discrepancy between D 1 and D s which is manifest in 110 000 gmol -1 PS/ 110 000 gmol -1 PVME/ toluene solutions at polymer volume fractions greater than 0.4 is investigated. The diffusion coefficient found, D 1 , does not fit a unique concentration power law. Two unique regions are seen with concentration exponents of -11±4 and -14.9±0.7 for the low and high concentration regions respectively. This is found to agree with results found in literature

Location of the target pitch within a vibrato wave

The current study investigated the relationship between the vibrato wave and the target pitch while eliminating some of the methodological problems that have plagued such research in the past. Three commercially-recorded selections were chosen for each of seven artists (for a total of 21 selections), and modern computer equipment was used to extract pitch information for each of six to fourteen notes from each selection. The chosen selections were all accompanied so that the target pitch could be determined from the accompaniment, and target pitch location within the vibrato wave was quantified absolutely and relatively. In general, the target pitch lay at or slightly below (average 4.29 cents below) the vibrato wave mean, and an analysis of variance revealed no significant differences between artists. Analyses of variance within each artist showed no differences between selections except for the soprano, who had one selection where the target pitch was generally above the vibrato wave mean

Living well, dying well - the importance of housing

David Clark and Sandy Whitelaw outline their vision for a new type of ‘care campus’ that would provide an environment in which older people, ranging from those able to live with complete independence to those with palliative care needs, would become part of the community of the Crichton Campus in dumfries

Quantum supergroups V. Braid group action

We construct a braid group action on quantum covering groups. We further use this action to construct a PBW basis for the positive half in finite type which is pairwise-orthogonal under the inner product. This braid group action is induced by operators on the integrable modules; however, these operators satisfy spin braid relations.Comment: v1. 31 pages v2. minor revisions, updated references, to appear in CM