The evaluation of capacity in dementia: ethical constraints and best practice. A systematic review

The progressive ageing of a population leads to an increase in the number of people suffering from cognitive deterioration. This requires particular attention in terms of the necessity to assess these people's cognitive functions and their capacity to make decisions. The present systematic review analyses the clinical and ethical aspects of any assessment of capacity, with a specific focus on the capacity of the individual to give informed consent for medical treatment and also with regard to their testamentary capacity. The results indicate that the concepts of capacity, competence and decision-making need to be better clarified, ad-hoc devised tools are required and a multidisciplinary, clinical and legal approach to assessments of capacity needs to be adopted. This is crucial to guarantee that the two ethical principles of capacity assessment are adhered to: respect for an individual's autonomy and the protection of fragile individuals

Agribusiness in times of planetary collapse: critical approaches

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Saúde ecossistêmica:: do inconsciente ecológico a um novo projeto de civilização

This article presents a discussion in the field of ecosystem health approaches that considers both the new discoveries concerning the Anthropocene Era and the shortcomings of the current sustainable development model. It is argued that a transdisciplinary-oriented ecosystem health concept should be coupled with a constructivist, co-evolving view of “human-beings-in-ecosystems” in contemporary environmental research. Such a perspective sets up a radical break with the epistemological Cartesian tradition. In this sense, the authors suggest that the main challenge to be tackled is the overcoming of the dualistic belief systems hegemonic in western culture. In addition, they assume that this move remains in tune with the search for an alternative civilizing project.Este artigo insere-se no debate em curso sobre abordagens ecossistêmicas em saúde de um ponto de vista sensível às incertezas geradas em uma época estigmatizada pela “grande aceleração do Antropoceno”. Sob o pano de fundo das aporias da visão neoliberal do desenvolvimento, os autores resgatam o potencial contido nas pesquisas mais recentes sobre o funcionamento da mente e da consciência, em busca de estruturas unificadoras nas imagens que forjamos do ser humano e da evolução da vida no planeta. Nesse sentido, a noção de saúde ecossistêmica é associada à pesquisa de novos padrões de entrelaçamento coevolutivo ”“ ou simbiótico ”“ dos seres humanos com o planeta. O texto sugere que sua adoção equivaleria a uma metamorfose dos sistemas dualistas de crenças que se tornaram hegemônicos na cultura do Ocidente, rumo à construção de um novo projeto de civilização

Ainda podemos escapar do Homo destructor? Um apelo à lucidez e à coragem

Resenha do livro:Gancille, J. M. Ne plus se mentir. Petit exercice de lucidité par temps d'effondrement écologique. Paris: Rue de l'échiquier, 2019.Book review:Gancille, J. M. Ne plus se mentir. Petit exercice de lucidité par temps d'effondrement écologique. Paris: Rue de l'échiquier, 2019

Uma nova ordem ecojurídica para regenerar a Terra

Dans cet entretien, Valérie Cabanes – juriste active dans le domaine de la protection des droits humains (et de la nature) – commente sa trajectoire militante et ses liens actuels avec le mouvement qui a pour but d’inclure le crime d’écocide dans le champ du droit international. Son témoignage met en lumière les contradictions et les anomalies du modèle agro-industriel mis en œuvre au Brésil, dans une perspective qui prend en compte la complexité du débat sur les limites planétaires de la croissance des économies néolibérales.Nesta entrevista, Valérie Cabanes – jurista atuante no campo da proteção dos direitos humanos (e da natureza) – comenta sua trajetória militante e suas conexões atuais com o movimento que visa incluir o crime de ecocídio no âmbito do Direito Internacional. Seu depoimento coloca em destaque as contradições e anomalias do modelo de agronegócio implantado no Brasil, de uma perspectiva que leva em conta a complexificação do debate sobre os limites planetários do crescimento das economias neoliberais

The Social (In)Visibility of Pollution Generated by the Application of Agrochemicals in the Irrigated Rice Production: Synthesis of a Study Concerning Risk Perception of Rural Communities Located in the Coastal Zone of Santa Catarina State

From the point of view of the ecosystem approach to health, this paper presents a reflection on the severalrisks posed by the uncontrolled use of chemical substances in the realm of food production in theBrazilian coastal zone. More precisely, it presents the main conclusions of a study of risk perceptions ofirrigated rice production in two watersheds located in the central southern coast of Santa Catarina State.The methodology used in this study took into account an ecotoxicological analysis (to measure part ofthe objective components of the situation of risk), followed by a diagnosis of risk perceptions to guidethe analysis of the social actors’ testimonies (stakeholders) involved in natural resource management:local residents, rural workers and government agents. The collected evidences suggest that local residentsseem to be aware of, yet indifferent about the negative effects to human health – and other living creatures– arising from the dominant patterns of irrigated rice cultivation. However, the structural factorsresponsible for the reproduction of this type of agro-ecosystem remain either diffuse or invisible. Thisgap has been systematically reinforced both by the government agents at various scales of the coastalzone management system and by the means of mass communication. Among the rice farmers an attitudeprevails that systematically minimizes the risks of intoxication, and the government agents tend toreproduce the same pattern of perception and reasoning as the entrepreneurs linked to the internationalsystem of production and dissemination of agro-chemicals. Facing these challenges, the authors suggesta more incisive application of the precautionary principle in the field of integrated and participativecoastal zone management, in order to counteract the ideology of economic growth “at any cost” thatviolates the inalienable right of the local communities to live healthily in a healthy environment, and to follow the ecodevelopment path.A partir do enfoque ecossistêmico em saúde, este artigo apresenta uma reflexão sobre os diversos riscosprovocados pelo uso descontrolado de substâncias químicas na produção de alimentos na zona costeirabrasileira. Mais precisamente, apresenta as principais conclusões de um estudo de percepção de riscosda produção de arroz irrigado em duas bacias hidrográficas localizadas na zona costeira centro-sul deSanta Catarina. A metodologia utilizada nesse estudo levou em conta uma avaliação ecotoxicológica(para mensurar parte dos componentes objetivos da situação de risco), seguida por um diagnóstico depercepção de riscos para orientar a análise dos depoimentos dos atores sociais (stakeholders) envolvidosna gestão dos recursos naturais: moradores locais, produtores rurais e agentes governamentais.As evidências recolhidas sugerem que a população local parece estar ciente – mas indiferente – ao quediz respeito aos efeitos negativos à saúde humana – e dos demais seres vivos – decorrentes do padrãodominante de cultivo irrigado de arroz. Entretanto, os fatores estruturais responsáveis pela reproduçãodeste tipo de agroecossistema permanecem difusos ou invisíveis. Esta lacuna tem sido reforçada sistematicamentepelos agentes governamentais em diversas escalas do sistema de gestão da zona litorâneae pelos meios de comunicação de massa. Entre os rizicultores prevalece uma atitude de minimização sistemática dos riscos de intoxicação e os agentes governamentais tendem a reproduzir a mesma lógicados empresários ligados ao sistema internacional de produção e difusão dos produtos agroquímicos.Frente a estes desafios, os autores sugerem uma aplicação mais incisiva do princípio da precaução nocampo da gestão integrada e participativa da zona litorânea para neutralizar a ideologia dominante decrescimento econômico “a qualquer custo”, que viola o direito inalienável das comunidades locais deviver com saúde em ambientes saudáveis e avançar na trilha do ecodesenvolvimento

Power Distribution System : load modeling of a Power Distribution System (PDS) for a medical imaging processor

Monografia (graduação)—Universidade de Brasília, Faculdade de Tecnologia, Departamento de Engenharia Elétrica, 2013.Philips Healthcare is researching and developing a new power distribution architecture that is intended to power different medical equipment, such as computed tomography, radiography, ultrasound and interventional X-ray equipment. The objective of this new architecture is to improve the safety in using these medical devices during operations, but it is further intended to power other non-medical devices as well. Some parts of the new architecture, like the power source and the Power Distribution System (PDS) have already been designed by Philips and former students. However, the load model that is connected to the system still needs to be tested and validated in order to have the whole architecture completed. Therefore, this report contains the results obtained after six months studying the loads characteristics of the system. A computational model was designed in LTspice IV software to predict the behavior of different loads when connected to the PDS. In the model, the load was represented by electronic components described by values that change over time. These values are set by the user with the purpose of analyzing the variations of voltage and currents during the load operation time, and they were carefully chosen in order to provide the results most similar to real life. After simulating, measurements with real loads in the X-Ray laboratory were analyzed and compared with the previous computational results. A validation tool was used to verify the closeness of the simulations to the practical measurements. In preparing and designing the models, an accuracy of 10% between the models and the practical results is expected

Fast and simple spectral FLIM for biochemical and medical imaging.

Spectrally resolved fluorescence lifetime imaging microscopy (λFLIM) has powerful potential for biochemical and medical imaging applications. However, long acquisition times, low spectral resolution and complexity of λFLIM often narrow its use to specialized laboratories. Therefore, we demonstrate here a simple spectral FLIM based on a solid-state detector array providing in-pixel histrogramming and delivering faster acquisition, larger dynamic range, and higher spectral elements than state-of-the-art λFLIM. We successfully apply this novel microscopy system to biochemical and medical imaging demonstrating that solid-state detectors are a key strategic technology to enable complex assays in biomedical laboratories and the clinic.A.E. thanks the EPSRC for the initial funding of the project (EP/F044011/1) from 2009 to 2011. M.P. and L.D.C. were supported by a Programme Grant to A.R.V. from the UK Medical Research Council (MRC). This project was also supported by the MRC’s grant-in-aid to the Cancer Unit, Cambridge (A.E., A.R.V.). C.F.K acknowledges funding from the MRC (grant MR/K015850/1), the Wellcome Trust (grant 089703/Z/09/Z) and the EPSRC (EP/L015889/1).This is the author accepted manuscript. The final version is available from the Optical Society of America via http://dx.doi.org/10.1364/OE.23.02351

Heritability and Demographic Analyses in the Large Isolated Population of Val Borbera Suggest Advantages in Mapping Complex Traits Genes

Isolated populations are a useful resource for mapping complex traits due to shared stable environment, reduced genetic complexity and extended Linkage Disequilibrium (LD) compared to the general population. Here we describe a large genetic isolate from the North West Apennines, the mountain range that runs through Italy from the North West Alps to the South.The study involved 1,803 people living in 7 villages of the upper Borbera Valley. For this large population cohort, data from genealogy reconstruction, medical questionnaires, blood, anthropometric and bone status QUS parameters were evaluated. Demographic and epidemiological analyses indicated a substantial genetic component contributing to each trait variation as well as overlapping genetic determinants and family clustering for some traits.The data provide evidence for significant heritability of medical relevant traits that will be important in mapping quantitative traits. We suggest that this population isolate is suitable to identify rare variants associated with complex phenotypes that may be difficult to study in larger but more heterogeneous populations

Using dengue epidemics and local weather in Bali, Indonesia to predict imported dengue in Australia.

BACKGROUND: Although the association between dengue in Bali, Indonesia, and imported dengue in Australia has been widely asserted, no study has quantified this association so far. METHODS: Monthly data on dengue and climatic factors over the past decade for Bali and Jakarta as well as monthly data on imported dengue in Australia underwent a three-stage analysis. Stage I: a quasi-Poisson regression with distributed lag non-linear model was used to assess the associations of climatic factors with dengue in Bali. Stage II: a generalized additive model was used to quantify the association of dengue in Bali with imported dengue in Australia with and without including the number of travelers in log scale as an offset. Stage III: the associations of mean temperature and rainfall (two climatic factors identified in stage I) in Bali with imported dengue in Australia were examined using stage I approach. RESULTS: The number of dengue cases in Bali increased with increasing mean temperature, and, up to a certain level, it also increased with increasing rainfall but dropped off for high levels of rainfall. Above a monthly incidence of 1.05 cases per 100,000, dengue in Bali was almost linearly associated with imported dengue in Australia at a lag of one month. Mean temperature (relative risk (RR) per 0.5 °C increase: 2.95, 95% confidence interval (CI): 1.87, 4.66) and rainfall (RR per 7.5 mm increase: 3.42, 95% CI: 1.07, 10.92) in Bali were significantly associated with imported dengue in Australia at a lag of four months. CONCLUSIONS: This study suggests that climatic factors (i.e., mean temperature and rainfall) known to be conducive of dengue transmission in Bali can provide an early warning with 4-month lead time for Australia in order to mitigate future outbreaks of local dengue in Australia. This study also provides a template and framework for future surveillance of travel-related infectious diseases globally