Competency to Stand Trial on Trial

This Article considers the legal standards for the determination of competency to stand trial, and whether those standards are understood and applied by psychiatrists and psychologists in the forensic evaluations they perform and in the judgments they make–judgments that are routinely accepted by trial courts as their own judgments. The Article traces the historical development of the competency construct and the development of two competency standards. One standard, used today in eight states that contain 25% of the population of the United States, requires that the defendant be able to assist counsel in the conduct of a defense “in a rational manner.” The second, adopted by the Supreme Court in Dusky v. United States, 362 U.S. 402 (1960) as the Court’s interpretation of the federal competency statute, requires that the defendant have an ability to consult with counsel with a reasonable degree of “rational understanding.” The “rational manner” standard seemingly focuses on the defendant’s behavior; the “rational understanding” standard seemingly focuses on the defendant’s thinking. The Article reports on a survey we conducted of 273 forensic psychiatrists and psychologists who were asked to read two case study vignettes and assess the competency of each criminal defendant using the “rational manner” standard, the “rational understanding” standard, and the federal statutory standard that merely requires that the defendant be able to “assist properly” in his or her defense. In one vignette, the defendant’s thinking was irrational but his behavior was rational. In the other, the defendant’s thinking was rational, but her behavior was irrational. In responding to both vignettes, more than three-fourths of all respondents either found the defendant competent under all three standards or incompetent under all three standards. Surprisingly, in answering the first vignette, the respondents divided almost equally in deciding whether the defendant was competent. The Article analyzes the results of the study and concludes with specific proposals to improve competency to stand trial assessments. Fairness to the defendant requires that the competency standard be clearly defined and applied by those who assess and determine competency

Serum Magnesium is an important predictor of frequent readmissions due to acute exacerbation of Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease is a disease which is characterized by obstruction of lung airflow which is over a chronic period and interferes with normal respiration, and is only partially reversible. COPD is not simply a cough of smoking people but a disease which is under-diagnosed as well as life threatening. Currently ranked as 5th leading cause of death worldwide and predicted 3rd up to 2020, it manifests an important public health problem which is both preventable as well as treatable. According to WHO estimates, 55 million people have moderate to severe COPD exacerbation. More than 3.5 million people died of COPD in 2004, which represents 5% of all deaths worldwide. The course of the disease is associated with exacerbations and they are hazardous as they are associated with significant mortality, morbidity, faster decline in lung function and increased health care utilization. Some studies focus a light on the role of magnesium in chronic respiratory diseases. Magnesium is involved in important functions of the respiratory system like dilatation of bronchus and bronchioles, stabilization of mast cells as well as clearance of debris in the mucociliary system. Hypomagnesemia is associated with increased airway hyperactivity, and thus impaired pulmonary function. It is said that due to its bronchodilating effect, a decreased level of magnesium may increase COPD exacerbations

Indigenous Elite and Modern Democracy: Case Study of Legislator at Gowa Regency

This paper aims to reveal 'lunge' indigenous elite that took place in a modern democratic society in Gowa, especially when the on going process of organizing elections out 2009. Some legislator selected 2009-2014 Gowa who had a background in traditional elite became evident how important power political bargaining in Gowa. Three of the members of parliament of the indigenous elite serve as the primary data source through in-depth interviews. The findings obtained are: indigenous elites who hav ea sound base large masses have strong political bargaining for gaining seats in parliament Gowa. Most of the indigenous elite who involved as a candidate does not have the capacity of education and political experience. Interestingly, they still dorationality political status attached to him

HUBUNGAN FAKTOR LINGKUNGAN DAN ANJURAN PENCEGAHAN DENGAN DBD DI WILAYAH KERJA PUSKESMAS KASSI-KASSI

DBD di Kota Makassar dalam 3 tahun terakhir cenderung menurun namun meningkat pada tahun 2013. Penderita DBD di Puskesmas Kassi-Kassi berturut-turut mulai tahun 2011 hingga 2013 yaitu 33, 7, dan 32 penderita. Penelitian ini bertujuan untuk mengetahui hubungan faktor lingkungan dan anjuran pencegahan oleh petugas kesehatan dengan kejadian DBD di wilayah kerja Puskesmas Kassi-Kassi. Jenis penelitian yang digunakan adalah observasional analitik dengan rancangan cross sectional study. Teknik pengambilan sampel exhaustive sampling. Sampel dalam penelitian ini adalah seluruh pasien yang berkunjung ke Puskesmas Kassi-Kassi dengan gejala DBD sebanyak 80 orang. Hasil penelitian menunjukkan terdapat dua variabel yang memiliki hubungan dengan kejadian DBD yaitu kondisi breeding place (p=0,041) dan keberadaan kawat kasa pada ventilasi (p=0,000) sedangkan tiga variabel tidak berhubungan dengan kejadian DBD yaitu kepadatan hunian rumah (p=0,919), saluran air hujan (p=0,540), dan anjuran pencegahan oleh petugas kesehatan (p=0,523). Kesimpulan dari penelitian ini bahwa ada hubungan kondisi breeding place dan keberadaan kawat kasa dengan kejadian DBD. Disarankan agar responden melakukan 3M Plus pada tempat potensial berkembangbiaknya nyamuk yang luput dari perhatian serta memasang kawat kasa pada ventilasi, jendela dan pintu

Karakteristik Dan Simulasi Sistem Kontrol Hidrolik Pada Proses Pengepresan Biji Jaraks Kepyar (Ricinus Communis L.)

This research aimed to study characteristic of hydraulic control system of castor beans pressing process. Experimental approach was conducted by using Complete Randomized Design to obtained relation between pressure\u27s variable and characteristics parameters of hydrolic control system and pressing process. Effet of pressure loading were investigated at 3, 5, 7, 9, and 11 kg, which replicated three times in order to obtained 15 units experiment. Characteristics parameters of hydraulic control system are pressure velocity, pressure, and pressure power. Pressing process parameters are distance of displacement, capacity of pressing process, and rendement. Result from this research showed that the hydraulic control system was able to transfered power using hydraulic oil in order to conduct pressing process. Higher loading pressure caused increasing pressure velocity, pressure, pressure power, pressing process capacity, and rendement. Whereas, lower loading pressure caused reduction on distance of displacement. Therefore, development on design is necessary to obtain optimal rendement quantity and further studies using extended pressure loading range is recommended

Identification of major factors influencing ELISpot-based monitoring of cellular responses to antigens from mycobacterium tuberculosis

A number of different interferon-c ELISpot protocols are in use in laboratories studying antigen-specific immune responses. It is therefore unclear how results from different assays compare, and what factors most significantly influence assay outcome. One such difference is that some laboratories use a short in vitro stimulation period of cells before they are transferred to the ELISpot plate; this is commonly done in the case of frozen cells, in order to enhance assay sensitivity. Other differences that may be significant include antibody coating of plates, the use of media with or without serum, the serum source and the number of cells added to the wells. The aim of this paper was to identify which components of the different ELISpot protocols influenced assay sensitivity and inter-laboratory variation. Four laboratories provided protocols for quantifying numbers of interferon-c spot forming cells in human peripheral blood mononuclear cells stimulated with Mycobacterium tuberculosis derived antigens. The differences in the protocols were compared directly. We found that several sources of variation in assay protocols can be eliminated, for example by avoiding serum supplementation and using AIM-V serum free medium. In addition, the number of cells added to ELISpot wells should also be standardised. Importantly, delays in peripheral blood mononuclear cell processing before stimulation had a marked effect on the number of detectable spot forming cells; processing delay thus should be minimised as well as standardised. Finally, a pre-stimulation culture period improved the sensitivity of the assay, however this effect may be both antigen and donor dependent. In conclusion, small differences in ELISpot protocols in routine use can affect the results obtained and care should be given to conditions selected for use in a given study. A pre-stimulation step may improve the sensitivity of the assay, particularly when cells have been previously frozen

Analisis Kemanfaatan Budaya Berbahasa Inggris Pada Sektor Pariwisata Berkelanjutan dI Era Industri 4.0

Abstract. English has an important role in the sustainable tourism sector through communication media with the aim of promoting abroad, service, good communication between foreign tourists and tourism actors, and the surrounding community which ultimately relates to the development of local tourism progress in the sustainable tourism sector in the industrial era. 4.0. Tourist actors must master English, especially the surrounding community, namely simple conversation, mastery of language and basic conversation. This study aims to examine the Benefits of English-Speaking Culture in the Sustainable Tourism Sector in the Industrial Era 4.0 in Gorontalo Province. The analytical method used is descriptive qualitative analysis. This paper shows that English-speaking culture in the sustainable tourism sector in the industrial era 4.0 in Gorotalo Province is needed with the aim of increasing foreign tourist visitors, facilitating communication using English and also as a promotional event abroad about local tourist destinations in the Province. Gorontalo. English has an important role in the tourism sector as a basis for people around tourist destinations and those who work in the tourism industry to be able to communicate well using English.Abstrak. Bahasa Inggris memiliki peran penting dalam sektor pariwisata berkelanjutan melalui media komunikasi dengan tujuan sebagai promosi ke luar negeri, pelayanan, komunikasi yang baik wisatawan asing dengan pelaku wisata, dan masyarakat sekitar yang pada akhirnya berhubungan dengan pengembangan kemajuan wisata lokal pada sektor pariwisata berkelanjutan di era industri 4.0. Pelaku wisata harus mengusai Bahasa Inggris terutama masyarakat sekitar yakni percakapan sederhana, penguasaan bahasa dan percakapan dasar. Penelitian ini bertujuan mengkaji Kemanfaatan Budaya Berbahasa Inggris Pada Sektor Pariwisata Berkelanjutan di Era Industri 4.0 di Provinsi Gorontalo. Metode analisis yang digunakan adalah analisis kualitatif deskriptif. Tulisan ini menunjukkan bahwa budaya berbahasa Inggris pada sektor pariwisata berkelanjutan di era industri 4.0 di Provinsi Gorotalo sangat diperlukan dengan tujuan untuk meningkatkan pengunjung wisatawan asing, memperlancar komunikasi dengan menggunakan Bahasa Inggris dan juga sebagai ajang promosi ke luar negeri tentang destinasi wisata lokal yang ada di Provinsi Gorontalo. Bahasa Inggris memiliki peranan penting dalam sektor pariwisata sebagai dasar bagi masyarakat sekitar destinasi wisata dan yang bekerja di industri pariwisata agar mampu berkomunikasi dengan baik menggunakan Bahasa Inggris.

The protective effect of rutin against renal toxicity induced by lead acetate

Flavonoids are known to have powerful antioxidant activity that could play a protective role in oxidative stress-mediated diseases. Rutin (RT) is a flavonol glycoside composed of the flavonol quercetin and disaccharide rutinose. The protective effect of RT against nephrotoxicity induced by lead acetate was evaluated. Male albino rats of Wistar strain were used in this study. Animals were given lead acetate after a week of pretreatment with RT (50 mg/animal/day). Lead acetate exposure resulted in an increase in the uric acid, creatinine (CRN) and blood urea nitrogen (BUN) levels and a decrease in glutathione, superoxide dismutase, catalase and glutathione peroxidase (GPx) activities. Lead acetate treatment decreased GSH levels by 2-fold and the activities of GSH metabolizing enzymes decreased to a range of 2–2.5-fold in renal tissue (p < 0.05). These changes were reversed significantly in animals receiving pretreatment of RT. Treatment of rats with RT prior to the treatment with lead resulted in the recovery of reduced levels of GSH, GSH-metabolizing enzymes to almost 85–90%. RT has a beneficial impact on lead-induced toxicity due to its scavenging and antioxidant effect in rats

Superior septal approach versus left atrial approach for mitral valve replacement: a retrospective cohort study

Abstract OBJECTIVE: To compare the outcomes of superior septal approach and left atrial approach for mitral valve replacement. METHODS: This retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, and comprised records of patients who had undergone isolated mitral valve replacement from May 2003 to April 2012. Cases were reviewed for the outcomes [primary: loss of normal sinus rhythm; secondary: complications, residual defect and mortality]. Patients with prior history of dysrhythmia, low ejection fraction (\u3c30%), emergency/redo mitral valve replacement and concomitant coronary artery bypass grafting were excluded. SPSS 19 was used for data analysis. RESULTS: Of the 78 patients, 52(66.67%) were of superior septal approach and 26(33.33%) of left atrial approach. Both groups were comparable for baseline variables except cardiopulmonary bypass and cross-clamp times, which were significantly shorter in the superior septal approach group than the left septal approach group (p\u3c0.05). No residual atrial septal defect was found in any approach. Although loss of normal sinus rhythm was observed more frequent in superior septal approach 25(48%) compared to left septal approach 10(38.4%), but the difference was statistically insignificant (p=0.28). Age was the only significant variable affecting loss of normal sinus rhythm after adjusting for approaches. The difference of post-operative complications was also statistically insignificant between superior 9(17.3%) and left septal approach 4(15.38%) (p=1.0)]. CONCLUSIONS: The operative durations were significantly higher in left atrial approach compared to superior septal approach