Differences between terminally ill cancer patients who died after euthanasia had been performed and terminally ill cancer patients who did not request euthanasia.

Palliative care, directed at improving the quality of life of terminally ill patients, is generally not aimed at any form of postponing or hastening death. It is possible that high quality palliative care could prevent requests for euthanasia. However, empirical evidence on this issue is scarce.

Dutch experience of monitoring euthanasia.

Doctors in the United Kingdom can accompany their patients every step of the way, up until the last. The law stops them helping their patients take the final step, even if that is the patient's fervent wish. Next month's debate in the House of Lords could begin the process of changing the law.

Signal optimisation in cw-laser crossed-beam photothermal spectrometry: influence of the chopping frequency, sample size and flow rate.

Optimisation of the optical design for cw-laser crossed-beam thermal lens spectrometry in infinite and finite samples has been investigated using different excitation beam waists and various lens combinations. The characteristics of the photothermal signal depending on the position of the sample with respect to the probe beam waist, the chopping frequency, the sample size and the flow rate have been considered. Depending on the irradiation duration, the size of the thermal element at the measurement time can be much greater than the waist of the excitation beam.

Linking nursing theory and practice: a critical-feminist approach.

Situated in a critical-feminist perspective, this article describes a pedagogical approach to linking nursing theory and practice. The inclusion of the critical humanities is emphasized in creating an environment in which this linkage can be reified for learners. Implications for the future of nursing theory and its links to practice in the context of current political realities in academia are considered.

The politics of suffering: implications for nursing science.

Drawing on newly emergent conceptualizations of suffering in the social sciences that emphasize political dimensions, this article uses a critical-feminist, self-reflective approach to propose a reconceptualization of suffering for nursing science. Discourse analysis of local narratives and metanarratives is undertaken as a basis for proposing alternative methods, including a critical humanities approach, for nurse scholars to use in creating a transformed, politicized epistemology of suffering.

Symptoms, treatment and "dying peacefully" in terminally ill cancer patients: a prospective study.

Goals: The aims of this study were to describe the symptoms, their treatment during the final months of life of terminally ill cancer patients and to assess characteristics of the dying process.

Patients And Methods: We used a prospective study design. From a representative sample of physicians who participated in a study of end-of-life decision making, we asked whether they were treating a patient with cancer whose treatment was no longer aimed at cure, whose life expectancy was probably longer than 1 week but no longer than 3 months and who would probably continue to be treated by the same physician until their death; 85 physicians completed a monthly questionnaire until patients' deaths.

Pulsed-laser crossed-beam thermal lens spectrometry for detection in a microchannel: influence of the size of the excitation beam waist.

Crossed-beam thermal lens spectrometry is especially designed for the detection of very small samples in capillary tubes and more generally in microfluidic devices. In this work, the effect of the size of the excitation beam with respect to the size of the sample microchannel has been investigated. Although the signal is inversely proportional to the size of the excitation waist into the sample, the use of large waists may provide greater sensitivities when short-pulse excitation lasers are used and allows easier optimization of the optical design.

Photothermal spectrometry for detection in miniaturized systems: relevant features, strategies and recent applications.

There is a growing interest in using miniaturized analytical devices because they allow to execute the different steps of an analytical process within very short times and with drastic reduction in the amounts of solvents, reagents and samples. As for capillary electrophoresis, these systems require detectors which are sensitive, versatile and adaptable to very small detection volumes. In this respect, photothermal spectrometry which is complementary to fluorescence seems to be a promising detection method.

Cw-laser thermal lens spectrometry in binary mixtures of water and organic solvents: composition dependence of the steady-state and time-resolved signals.

The thermal lens effect obtained in binary liquid systems composed of water and ethanol, propanol and acetonitrile has been investigated. The dependence of dn/dT upon the solvent volume fraction follows polynomials up to sixth order and cannot be precisely predicted using the additive rule. The sensitivity of the thermal lens method upon the addition of organic solvent in water varies as the temperature-dependent refractive index gradient to thermal conductivity ratio of the mixture provided that the signal is sampled correctly.

Endangered species: where leatherback turtles meet fisheries.

The dramatic worldwide decline in populations of the leatherback turtle (Dermochelys coriacea) is largely due to the high mortality associated with their interaction with fisheries, so a reduction of this overlap is critical to their survival. The discovery of narrow migration corridors used by the leatherbacks in the Pacific Ocean raised the possibility of protecting the turtles by restricting fishing in these key areas. Here we use satellite tracking to show that there is no equivalent of these corridors in the North Atlantic Ocean, because the turtles disperse actively over the whole area.

Change in plasma cortisol and metabolites during the attendance period ashore in fasting lactating subantarctic fur seals.

Lactating fur seals (Arctocephalus tropicalis) alternate foraging trips at sea and pup attendance periods ashore. During the onshore nursing periods, lactating females do not have access to food and meet both their own metabolic requirements and milk production from their body reserve. Blood and milk samples were collected from females captured soon after their arrival ashore from a foraging trip and before their departure.

Investigation of the optimum optical design for pulsed-laser crossed-beam thermal lens spectrometry in infinite and finite samples.

Optimization of the optical design for pulsed-laser crossed-beam thermal lens (PLCBTL) spectrometry has been investigated. Experiments have been carried out with large samples as well as for very small samples in a microchannel and using different lens combinations to focus the probe and excitation beams. The results have been interpreted in terms of the influence of the excitation beam size as well as the degree of mode-mismatching of the excitation and probe beams on the optimum sample position and on the amplitude and decay of the photothermal signal.

Deconstructing clinical pathways: mapping the landscape of health care.

Grounded in a critical feminist methodology, this article undertakes a deconstructive discourse analysis of a newly emergent discourse within nursing care management, "clinical pathways." Using a Foucaultian approach to deconstructive discourse analysis, the power relations inherent in the "clinical pathways" discourse are identified and the underlying philosophical assumptions informing the discourse are explored. The metaphors of "map" and "landscape" are employed to examine the power relations within the discourse of "clinical pathways.

Undocumentedness and liminality as health variables.

The growing exodus of indigenous people from Mexico into the United States, especially from the multiethnic state of Oaxaca, is used as an exemplar of the global phenomenon of transnational migration and its effects on health. Lately, indigenous Oaxacan women have become a predominant part of this diaspora in the United States. Driven by economic desperation most arrive across the border as undocumented persons that configure them into multiple liminal spaces inimical to health and well-being.

Impact of pathogen burden in patients with coronary artery disease in relation to systemic inflammation and variation in genes encoding cytokines.

The number of infectious pathogens to which an individual has been exposed (pathogen burden) has been linked to the development and the prognosis of coronary artery disease (CAD). The interaction among infection, genetic host susceptibility, and CAD remains unclear. This study was aimed at evaluating the modulation of the association between CAD and pathogen burden, by serum levels of inflammatory markers and polymorphisms of the interleukin (IL)-6 and tumor necrosis factor (TNF)-alpha genes.

Suffering: toward a contextual praxis.

Janice M. Morse's article in Advances in Nursing Science (24:1) revised and summarized the major findings of a research program exploring the behavioral-experiential nature of suffering. Using a feminist critical theory stance, this article addresses Morse's conceptualization of a praxis of suffering.

Comprehensive study of the luminescent properties and lifetimes of Eu(3+) and Tb(3+) chelated with various ligands in aqueous solutions: influence of the synergic agent, the surfactant and the energy level of the ligand triplet.

The formation and the properties of luminescent complexes of europium and terbium with a variety of organic ligands have been investigated in aqueous solutions. The ligands used include model compounds such as thenoyltrifluoroacetone and pyridine-2,6-dicarboxylic acid and organic analytes of biological or pharmaceutical interest. It is shown that the formation and the luminescent properties of these complexes depend at first on several parameters including the pH and the buffer, the synergic agent and the surfactant.

An emerging discourse: toward epistemic diversity in nursing.

Grounded in a postmodern feminist methodology, this article undertakes an initial analysis of a newly emerging discourse in contemporary nursing academia in the United States. Two currently prominent discourses in nursing, a dominant discourse informed by the processes and values of "science" in the Enlightenment sense and a concurrent marginalized discourse informed by postmodernism, are described as a context for the emerging discourse. A genealogy informed by the work of Foucault is presented as a basis for an analysis of the power effects resulting from the conflict between these 2 discourses.

Investigation of the diffusion coefficient of polymers and micelles in aqueous solutions using the Soret effect in cw-laser thermal lens spectrometry.

The concentration gradient (Soret effect) induced in cw-laser thermal lens spectrometry subsequently to the formation of the thermal gradient (thermal lens effect) has been investigated in aqueous solutions of various macromolecular species including micelles, mixed micelles and polymers. It is shown that the build-up of the concentration gradient is much shorter than that in classical Soret experiments, reaching steady-state values in less than 1 min. The time evolution of the Soret signal has been used to derive mass-diffusion times from which mass-diffusion coefficients were calculated.

Being a palliative care nurse in an academic hospital: a qualitative study about nurses' perceptions of palliative care nursing.

The original philosophy of palliative care emphasizes the importance of the integration of compassion and medical science. The meaning palliative care nurses assign to their relationships with patients has been described in several studies. This qualitative research was undertaken in order to elicit the way nurses working on a palliative care ward in an academic hospital perceive their role and gain insight into the problems they encounter.

Pulsed-laser mode-mismatched crossed-beam thermal lens spectrometry within a small capillary tube: effect of flow rate and beam offset on the photothermal signal.

Pulsed-laser crossed-beam thermal lens spectrometry within a small capillary tube has been investigated using static as well as flowing samples. It is shown that when both the excitation and probe beams are perfectly aligned, time-resolved and peak signals are adequately described by the theoretical relations previously reported for infinite samples. Depending on flow velocity and/or the lateral offset between excitation and probe beam axis, the optical element formed by the excitation beam may have a diverging or converging effect on the probe beam.

Sensing wave-front amplitude and phase with phase diversity.

We show in benchtop experiments that wave-front phase estimation by phase diversity can be significantly improved by simultaneous amplitude estimation. Processing speed, which will be important for real-time wave-front control applications, can be enhanced by use of small-format detectors with pixels that do not fully sample the diffraction limit. Using an object-independent phase-diversity algorithm, we show that, for both pointlike and extended objects, the fidelity of the phase and amplitude estimates degrades gracefully, rather than catastrophically, as the sampling becomes coarser.

Moral problems experienced by nurses when caring for terminally ill people: a literature review.

This article is a review of the literature on the subject of how nurses who provide palliative care are affected by ethical issues. Few publications focus directly on the moral experience of palliative care nurses, so the review was expanded to include the moral problems experienced by nurses in the care of the terminally ill patients. The concepts are first defined, and then the moral attitudes of nurses, the threats to their moral integrity, the moral problems that are perceived by nurses, and the emotional consequences of these moral problems are considered in turn.