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Background:
Specialised palliative home-care supports patients with life-limiting diseases in their familiar surroundings. The number of palliative care teams and patients being cared for is increasing worldwide. To assess and improve quality, it is needed to understand, how specialised palliative home-care can be provided successfully. For this purpose we examined the views of all involved stakeholders.
Aim:
To identify the issues that patients, their relatives and involved health professionals view as important in ensuring the success of specialised palliative home-care.
Design:
We used a qualitative design based on participant observations, interviews and focus groups following the principles of a Grounded Theory approach.
Setting/participants:
All specialised palliative home-care teams (n = 22) caring for adults in Hesse, Germany, participated. We conducted participant observations (n = 5), and interviewed patients (n = 14), relatives (n = 14) and health professionals working in or collaborating with specialised palliative home-care (n = 30). We also conducted focus groups (n = 4) with health professionals including a member check.
Results:
Successful specialised palliative home-care needs to treat complex symptoms, and provide comprehensive care including organisation of care, involving relatives and addressing issues of death and dying. Sense of security for patients and relatives is key to enable care at home. Care delivery preferences include a focus on the quality of relationships, respect for individuality and the facilitation of self-determination.
Conclusions:
Consideration of the identified key issues can help to ensure successful specialised palliative home-care. Knowledge of these should also be considered when researching and assessing quality of care.
Trial registration:
German Clinical Trials Register DRKS-ID: DRKS00012421; http://www.germanctr.de.
Chromosomal translocations (CTs) are a genetic hallmark of cancer. They could be identified as recurrent genetic aberrations in hemato-malignancies and solid tumors. More than 40% of all “cancer genes” were identified in recurrent CTs. Most of these CTs result in the production of oncofusion proteins of which many have been studied over the past decades. They influence signaling pathways and/or alter gene expression. However, a precise mechanism for how these CTs arise and occur in a nearly identical fashion in individuals remains to be elucidated. Here, we performed experiments that explain the onset of CTs: (1) proximity of genes able to produce prematurely terminated transcripts, which lead to the production of (2) trans-spliced fusion RNAs, and finally, the induction of (3) DNA double-strand breaks which are subsequently repaired via EJ repair pathways. Under these conditions, balanced chromosomal translocations could be specifically induced. The implications of these findings will be discussed.
Spectroscopic responses of the potentiometric probe 2-(4-(dimethylamino)styryl)-1-methylpyridinium iodide (DASPMI) were investigated in living cells by means of a time- and space-correlated single photon counting technique. Spatially resolved fluorescence decays from single mitochondria or only a very few organelles of XTH2 cells exhibited three-exponential decay kinetics. Based on DASPMI photophysics in a variety of solvents, these lifetimes were attributed to the fluorescence from the locally excited state, intramolecular charge transfer state, and twisted intramolecular charge transfer state. A considerable variation in lifetimes among mitochondria of different morphologies and within single cells was evident, corresponding to high physiological variations within single cells. Considerable shortening of the short lifetime component ({tau}1) under a high-membrane-potential condition, such as in the presence of ATP and/or substrate, was similar to quenching and a dramatic decrease of lifetime in polar solvents. Under these conditions {tau}2 and {tau}3 increased with decreasing contribution. Inhibiting respiration by cyanide resulted in a notable increase in the mean lifetime and a decrease in mitochondrial fluorescence. Increased DASPMI fluorescence under conditions that elevate the mitochondrial membrane potential has been attributed to uptake according to Nernst distributions, delocalization of {pi}-electrons, quenching processes of the methyl pyridinium moiety, and restricted torsional dynamics at the mitochondrial inner membrane. Accordingly, determination of anisotropy in DASPMI-stained mitochondria in living cells revealed a dependence of anisotropy on the membrane potential. The direct influence of the local electric field on the transition dipole moment of the probe and its torsional dynamics monitor changes in mitochondrial energy status within living cells.
THE PRESENT ARTICLE TRIES TO DEMYSTIFY THE LINK BETWEEN THE SUBPRIME BANKING CRISIS AND THE SUBSEQUENT FALL IN GROSS DOMESTIC PRODUCT. AN UP-TO-DATE REVIEW OF THE LITERATURE ON THE REAL CONSEQUENCES OF THE LOSS OF BANK LENDING CAPACITY IS PROVIDED, PRESENTING EVIDENCE OF A DECLINE IN NEW BANK LOANS ALONG WITH EVIDENCE OF CORPORATE REACTIONS TO THIS DECLINE. FINALLY, IT IS SHOWN HOW THE PRESENTED FACTS CAN ADD UP TO AN EVENT OF MACROECONOMIC DIMENSION.
EXTANT STRATEGY CONCEPTS ARE CHALLENGED DUE TO THE ONGOING DIGITIZATION, WHICH FUNDAMENTALLY CHANGES CONDITIONS FOR ALL MARKET PARTICIPANTS. THIS RESEARCH COMPARES THE CONCEPT OF IT ALIGNMENT WITH THE RECENTLY INTRODUCED “DIGITAL BUSINESS STRATEGY” (DBS), WHICH DESCRIBES A CROSS-FUNCTIONAL AND AGILE FUSION OF BUSINESS AND IT STRATEGY. THE RESULTS REVEAL A TOTAL ABSENCE OF A DIRECT INFLUENCE OF IT LEADERS (CIOS) ON DBS, WHEREAS A HIGH IMPACT ON IT ALIGNMENT IS STILL GIVEN. BUSINESS LEADERS IN TURN IMPACT MORE ON DBS.
Although researchers and practitioners increasingly focus on health promotion in organizations, research has been mainly fragmented and fails to integrate different organizational levels in terms of their effects on employee health. Drawing on organizational climate and social identity research, we present a cascading model of organizational health climate and demonstrate how and when leaders' perceptions of organizational health climate are linked to employee well-being. We tested our model in two multisource studies (NStudy 1 = 65 leaders and 291 employees; NStudy 2 = 401 leader–employee dyads). Results showed that leaders' perceptions of organizational health climate were positively related to their health mindsets (i.e., their health awareness). These in turn were positively associated with their health-promoting leadership behavior, which ultimately went along with better employee well-being. Additionally, in Study 1, the relationship between perceived organizational health climate and leaders' health mindsets was moderated by their organizational identification. High leader identification strengthened the relationship between perceived organizational health climate and leaders' health mindsets. These findings have important implications for theory and practice as they show how the dynamics of an organizational health climate can unfold in organizations and how it is related to employee well-being via the novel concept of health-promoting leadership.
Although researchers and practitioners increasingly focus on health promotion in organizations, research has been mainly fragmented and fails to integrate different organizational levels in terms of their effects on employee health. Drawing on organizational climate and social identity research, we present a cascading model of organizational health climate and demonstrate how and when leaders' perceptions of organizational health climate are linked to employee well‐being. We tested our model in two multisource studies (NStudy 1 = 65 leaders and 291 employees; NStudy 2 = 401 leader–employee dyads). Results showed that leaders' perceptions of organizational health climate were positively related to their health mindsets (i.e., their health awareness). These in turn were positively associated with their health‐promoting leadership behavior, which ultimately went along with better employee well‐being. Additionally, in Study 1, the relationship between perceived organizational health climate and leaders' health mindsets was moderated by their organizational identification. High leader identification strengthened the relationship between perceived organizational health climate and leaders' health mindsets. These findings have important implications for theory and practice as they show how the dynamics of an organizational health climate can unfold in organizations and how it is related to employee well‐being via the novel concept of health‐promoting leadership.
The relationship between the beetle family Eucnemidae and the parasitic proctotrupoid family Vanhorniidae is discussed. The only proven host for Vanhornia eucnemidarum Crawford in North America is an undetermined species of the genus Isorhipis Boisduval and Lacordaire. In Europe, the only known host for Vanhornia leileri Hedqvist is Hylis cariniceps (Reitter). The biologies of the hosts differ radically and it appears unlikely that they could be parasitized in a typical proctotrupoid fashion in which eggs are placed in or on the host larva. This supports the hypothesis that small Vanhorniidae larvae attach themselves to the newly hatched beetle larvae, before they enter the wood on which they feed. The taxonomy of the genus Vanhornia Crawford is briefly discussed.
The present article illustrates that the specific articulatory and aerodynamic requirements for voiced but not voiceless alveolar or dental stops can cause tongue tip retraction and tongue mid lowering and thus retroflexion of front coronals. This retroflexion is shown to have occurred diachronically in the three typologically unrelated languages Dhao (Malayo-Polynesian), Thulung (Sino-Tibetan), and Afar (East-Cushitic). In addition to the diachronic cases, we provide synchronic data for retroflexion from an articulatory study with four speakers of German, a language usually described as having alveolar stops. With these combined data we supply evidence that voiced retroflex stops (as the only retroflex segments in a language) did not necessarily emerge from implosives, as argued by Haudricourt (1950), Greenberg (1970), Bhat (1973), and Ohala (1983). Instead, we propose that the voiced front coronal plosive /d/ is generally articulated in a way that favours retroflexion, that is, with a smaller and more retracted place of articulation and a lower tongue and jaw position than /t/.