Taking Conscience Seriously or Seriously Taking Conscience: Obstetricians, Specialty Boards, and the Takings Clause

The article discusses the legal implications of conscience in obstetricians and healthcare providers. It provides background on controversies related to abortion and conscience in obstetricians. It explains why a decertification by the American Board of Obstetricians and Gynecologists (ABOG) based on noncompliance with the College in Ethics Opinion No. 385 could constitute a regulatory taking. It analyzes whether or not ABOG satisfies the state action doctrine\u27s public function rules

Adult Education in the End of the Century: A Reflective Review from Portugal

In this paper we review adult education policies in Portugal from 1974 until 1999, and we also try to provide a realistic portrait of the current situation. Our main aim is to give suggestions to guide researchers in this field of work

Influencia del tipo de derivado celulósico sobre la textura y la estabilidad oxidativa y térmica de oleogeles de aceite de soja

The use oleogels (defined as edible oils entrapped in a three-dimensional network employing a self-assembled structuring agent) has recently been proposed to replace saturated fat or trans-fats in foods. In this work the effects of different cellulose derivative mixtures (Avicel, ethyl cellulose and α-cellulose) on lipid stability, glass transition temperature and the texture of soybean oil oleogels were determined by employing a mixture design approach. Avicel affected lipid stability, increasing the oxidative rancidity and peroxide values of oleogels. Oleogels with higher proportions of Avicel also presented higher transition temperatures. A higher percent of ethyl cellulose and α-cellulose in the oleogel mixture resulted in a more stable system with lower oil rancidity and lower glass transition temperatures. In addition, Avicel resulted in a softer and less tacky texture, an important characteristic to consider for food applications.Recientemente, ha sido propuesto el uso de oleogeles (definido como aceites comestibles atrapados en una red tridimensional que ocupa un agente estructurante de auto-ensamblado) como substituto de grasa saturada o grasas trans en alimentos. En este trabajo el efecto de mezclas de diferentes derivados celulósicos (Avicel, etil celulosa y α-celulosa) sobre la estabilidad de lípidos, temperaturas de transición térmica y textura de oleogeles de aceite de soja fueron determinados utilizando un diseño de mezclas. Avicel afectó la estabilidad de lípidos, aumentando la rancidez oxidativa y valores de peróxido en los oleogeles. Oleogeles con mayores proporciones de Avicel también presentaron temperaturas de transición térmica más altas. Porcentajes más altos de etil celulosa y α-celulosa resultaron en un sistema más estable con menor rancidez oxidativa y menores temperaturas de transición térmica. Sin embargo, Avicel resultó en una textura más suave y menos pegajosa, una característica importante a considerar para su aplicación en alimentos

Regionalization and susceptibility assessment to daily precipitation extremes in mainland Portugal

The present study aims to identify regions of extreme precipitation in mainland Portugal and to create a single index of extreme precipitation susceptibility (EPSI). For this purpose, twelve extreme precipitation indices were selected from the Expert Team on Climate Change Detection and Indices between 1950 and 2003. By considering only six extreme precipitation indices: R 1day, R 5day, SDII, R20, CWD and R95PTOT for the 10-year return period, between 1950 and 2003, the EPSI was developed to both annual data and meteorological season. The regionalization of extreme precipitation in Portugal were determined using a principal component analysis in T-mode. The results, show three spatial regions obtained from PCA. The three regions were analyzed separate. In the annual EPSI, the highest susceptibility areas are the mountainous regions in northern (e.g. Geres, Peneda, Alv ^ ~ ao, Marao and Montesinho) and central ~ Portugal (e.g. Serra da Estrela), as well as in the Algarve (southern Portugal). Conversely, the lower susceptibility classes are in municipalities of the northeast, Alentejo and along the central-western coast. The results of EPSI show similar results in autumn and winter. In spring, however, the high susceptibility class increases in the Lisbon region and in the Sado Basin. In summer, there is an increase in susceptibility in the northeast, while susceptibility is low over much of Alentejo and Algarve, where precipitation is neglectful. This work presents a first attempt to implement this type of index for mainland Portugal. The first results are very promising, showing a consistent representation of the overall spatial distribution of extreme precipitation susceptibility. The combination of this information by municipalities can be of foremost relevance to civil protection and risk management.info:eu-repo/semantics/publishedVersio

Visibilidad de las publicaciones cubanas en el Indice Mexicano de Revistas Biomédicas Latinoamericanas

Popularity and visibility of Serial Cuban publication´s in the Mexican Index of Latin American Biomedical Journals (IMBIOMED) are analyzed take into account some cibermetric indicators selected to fulfill this purpose. The countries with the greater contributions to IMBIOMED, the most discussed subjects and the number of website visits from 1999 to 2004 as well as its distribution, the most productive authors, the most frecuency read and downloaded article among others were determined. Aimed at determining the most popular Cuban journals a general index was develop according to position of each serial publication according to individual indicators. IMBIOMED processes 98 biomedical serial publications from 9 countries among then Cuba and Mexico having 58 and 29 respectively were the best represented. Among the 36 specialties treated in IMBIOMED the most important were General Medicine, Pediatrics, Neurology, odontology and Oncology. The Cuban journal´s of pediatrics, obstetrics and gynecology, General Integral Medicine were the most frecuently downloded in the research period. Acta Medica presented the highest download average according to proccesed article (24.5). The Revista Cubana de Obstetricia y Ginecología and the Revista Cubana de Pediatría reached the highest popularity indexes. IMBIOMED is a valuable tool for professionals of Latin America. The spread of its documental coverage facilitates the use of Latin American medical and scientific production as well as the assessment of visibility and popularity of biomedical journals of this region according to cibermetric indicators

Hematoproteinuria in a Lupic Patient with Diabetes: Which One is the Winner?

We report the case of a 46-year-old woman referred to nephrology consult for non-nephrotic proteinuria and hematuria.info:eu-repo/semantics/publishedVersio

Earthworm management in tropical agroecosystems

A worldwide survey of earthworms in the humid tropics revealed that 51 exotics and 151 native species are commonly found in tropical agroecosystems. On the basis of frequency records and climatic and edaphic ranges, 21 exotics and 27 native species have been selected as possible candidates for manipulation. A multivariate analysis separated these species into four groups : (i) native species with wide edaphic and medium climatic tolerances ; (ii) exotic species with wide climatic and edaphic tolerances ; (iii) native and exotic species with narrow edaphic tolerances but more resistant to climatic variations ; and (iv) native species with limited tolerance for climatic and edaphic variations. Regarding management, species of group (ii) seem to be the most adaptable, both at regional and local levels (multipurpose species) ; group (i) can be managed for specific climatic conditions whereas group (iii) should be managed in specific soil environments. Species of group (iv) may only be managed at a very local scale. (Résumé d'auteur

Individualized Absolute Risk Calculations for Persons with Multiple Chronic Conditions: Embracing Heterogeneity, Causality, and Competing Events

Approximately 75% of adults over the age of 65 years are affected by two or more chronic medical conditions. We provide a conceptual justification for individualized absolute risk calculators for competing patient-centered outcomes (PCO) (i.e. outcomes deemed important by patients) and patient reported outcomes (PRO) (i.e. outcomes patients report instead of physiologic test results). The absolute risk of an outcome is the probability that a person receiving a given treatment will experience that outcome within a pre-defined interval of time, during which they are simultaneously at risk for other competing outcomes. This allows for determination of the likelihood of a given outcome with and without a treatment. We posit that there are heterogeneity of treatment effects among patients with multiple chronic conditions (MCC) largely depends on those coexisting conditions. We outline the development of an individualized absolute risk calculator for competing outcomes using propensity score methods that strengthen causal inference for specific treatments. Innovations include the key concept that any given outcome may or may not concur with any other outcome and that these competing outcomes do not necessarily preclude other outcomes. Patient characteristics and MCC will be the primary explanatory factors used in estimating the heterogeneity of treatment effects on PCO and PRO. This innovative method may have wide-spread application for determining individualized absolute risk calculations for competing outcomes. Knowing the probabilities of outcomes in absolute terms may help the burgeoning population of patients with MCC who face complex treatment decisions