Mental Capacity and Decisional Autonomy: An Interdisciplinary Challenge

With the waves of reform occurring in mental health legislation in England and other jurisdictions, mental capacity is set to become a key medico-legal concept. The concept is central to the law of informed consent and is closely aligned to the philosophical concept of autonomy. It is also closely related to mental disorder. This paper explores the interdisciplinary terrain where mental capacity is located. Our aim is to identify core dilemmas and to suggest pathways for future interdisciplinary research. The terrain can be separated into three types of discussion: philosophical, legal and psychiatric. Each discussion approaches mental capacity and judgmental autonomy from a different perspective yet each discussion struggles over two key dilemmas: whether mental capacity and autonomy is/should be a moral or a psychological notion and whether rationality is the key constitutive factor. We suggest that further theoretical work will have to be interdisciplinary and that this work offers an opportunity for the law to enrich its interpretation of mental capacity, for psychiatry to clarify the normative elements latent in its concepts and for philosophy to advance understanding of autonomy through the study of decisional dysfunction. The new pressures on medical and legal practice to be more explicit about mental capacity make this work a priority

Executive Summary: Evaluation of the MacArthur Foundation's Human Rights and International Justice Grantmaking in Nigeria 2000-2012

The MacArthur Foundation commissioned Itad to conduct an evaluation of the Foundation's Human Rights and International Justice (HRIJ) grant?making program in Nigeria between 2000 and 2012. During this period, the Foundation supported 102 HRIJ projects with an end?date in 2000 or later, for a total grant amount of US$23,945,010. The projects broadly fell within the following thematic categories:- Accountability of democratic institutions, including the police- Justice: legal and judicial reform, including international justice standards - Protection and promotion of human rightsThe evaluation was commissioned to seek answers to the following questions: - Approach and strategy: o What has changed in the wider Nigerian HRIJ landscape in Nigeria since 2000? o What was the Foundation's HRIJ grantmaking strategy in Nigeria over this time? o How has the Foundation responded to change in the wider environment? o How has the implementation of grants contributed to strategic aims? - Impact: o What have been the main results of the Foundation's investments? o What was the Foundation's primary contribution to Nigeria HRIJ issues? o What lessons can be drawn for future HRIJ grantmaking in Nigeria

Decision-making capacity for treatment in psychiatric and medical in-patients: Cross-sectional, comparative study

BackgroundIs the nature of decision-making capacity (DMC) for treatment significantly different in medical and psychiatric patients?AimsTo compare the abilities relevant to DMC for treatment in medical and psychiatric patients who are able to communicate a treatment choice.MethodA secondary analysis of two cross-sectional studies of consecutive admissions: 125 to a psychiatric hospital and 164 to a medical hospital. The MacArthur Competence Assessment Tool – Treatment and a clinical interview were used to assess decision-making abilities (understanding, appreciating and reasoning) and judgements of DMC. We limited analysis to patients able to express a choice about treatment and stratified the analysis by low and high understanding ability.ResultsMost people scoring low on understanding were judged to lack DMC and there was no difference by hospital (P=0.14). In both hospitals there were patients who were able to understand yet lacked DMC (39% psychiatric v. 13% medical in-patients, P&lt;0.001). Appreciation was a better ‘test’ of DMC in the psychiatric hospital (where psychotic and severe affective disorders predominated) (P&lt;0.001), whereas reasoning was a better test of DMC in the medical hospital (where cognitive impairment was common) (P=0.02).ConclusionsAmong those with good understanding, the appreciation ability had more salience to DMC for treatment in a psychiatric setting and the reasoning ability had more salience in a medical setting.</jats:sec

The Effects of Human Behavioral Changes due to the COVID-19 Pandemic on the Reservoir of Lytic Escherichia coli and Staphylococcus aureus Bacteriophage on Humans at a South Carolina University

Bacteriophages are viruses, whose unique ability to infect and lyse bacterial cells may provide valuable insight for evading the repercussions of a post-antibiotic era in medicine. This study isolated and characterized Escherichia coli and Staphylococcus aureus bacteriophage on students and faculty at Coastal Carolina University as a means to understand the viability of human bacteriophage reservoirs for bacteriophage therapy. From September 2021 to March 2022, nasal and postauricular swab samples and a behavioral survey were collected from ninety-three randomly selected participants. Additionally, sixteen participants contributed nasal and postauricular swab samples and a behavioral survey on a monthly basis in a longitudinal study. The purpose of this study was to establish insight into behavioral factors, namely face mask wearing, handwashing/ sanitizing, and perceived stress levels, that potentially contribute to the E. coli and S. aureus bacteriophage dynamics. During the current collection cycle, 2021-2022, there has been a reemergence of bacteriophage since their disappearance the previous collection year. Results indicate participant engagement in mask wearing or handwashing/ sanitizing does not affect coliphage presence, but participants with coliphage presence generally had lower perceived stress levels than those lacking coliphage. Data was limited and correlations could not be made between S. aureus bacteriophage presence and the aforementioned behavioral factors. However, limited data suggests face mask wearing may be correlated to a lack of S. aureus bacteriophage presence on a host

Retractable Hammock

This Final Design Review will recap the objectives, background, design ideation, and concept development of the Retractable Hammock senior capstone project and continue to report on the final design and manufacturing that resulted in the final iteration of the Retractable Hammock

Prospectus, April 11, 2001

https://spark.parkland.edu/prospectus_2001/1012/thumbnail.jp

Investigation of Staphylococcus aureus Bacteriophage Population at a South Carolina University: The Disappearance of S. aureus Bacteriophage Population Amidst the COVID-19 Pandemic

Bacteriophages are naturally occurring, nonpathogenic viruses, which infect bacterial cells. Recently, bacteriophage research has increased with hopes of using them against antibiotic resistant bacterial infections in the future. This study aimed to determine a possible correlation between perceived stress and the Staphylococcus aureus bacteriophage population at Coastal Carolina University (CCU), Conway, South Carolina, using isolation and characterization techniques to further understand humans as a potential bacteriophage source. From October 2020 to March 2021, nasal and postauricular swab samples were collected from 12 participants on a monthly basis along with a perceived stress survey. Samples were subjected to filtration, amplification, plaque assays, and PCR techniques to identify and characterize bacteriophage. The purpose of this study was to understand humans as a repository for bacteriophage and to understand factors, namely perceived stress, which affect bacteriophage presence on humans. Results suggested that possible changes due to the COVID-19 pandemic, such as increased stress levels, mask wearing, and constant hand washing/ sanitizing, caused a drastic decrease in the Escherichia coli and Staphylococcus aureus phage population at Coastal Carolina University