United States v. Ruiz-Gaxiola: Setting the Standard For Medicating Defendants Involuntarily in the Ninth Circuit

In United States v. Ruiz-Gaxiola, the United States Court of Appeals for the Ninth Circuit held that the government could not medicate a defendant involuntarily for the sole purpose of rendering the defendant competent to stand trial. The court relied on the Sell test in making its determination. In Sell v. United States, the United States Supreme Court established a four-pronged test for determining whether a court should grant a request to medicate a defendant involuntarily. A court may not grant such a request unless the government shows that (1) an important government interest is at stake in prosecuting the defendant to be medicated, (2) medicating the defendant involuntarily will significantly further the important government interest, (3) medicating the defendant involuntarily is necessary to further the important government interest, and (4) the involuntary medication of the defendant is medically appropriate. The Ninth Circuit held that because the government failed to establish the facts necessary to satisfy all four prongs of the Sell test by clear and convincing evidence, the district court erred in authorizing the involuntary medication of the defendant

United States v. Ruiz-Gaxiola: Setting the Standard For Medicating Defendants Involuntarily in the Ninth Circuit

In United States v. Ruiz-Gaxiola, the United States Court of Appeals for the Ninth Circuit held that the government could not medicate a defendant involuntarily for the sole purpose of rendering the defendant competent to stand trial. The court relied on the Sell test in making its determination. In Sell v. United States, the United States Supreme Court established a four-pronged test for determining whether a court should grant a request to medicate a defendant involuntarily. A court may not grant such a request unless the government shows that (1) an important government interest is at stake in prosecuting the defendant to be medicated, (2) medicating the defendant involuntarily will significantly further the important government interest, (3) medicating the defendant involuntarily is necessary to further the important government interest, and (4) the involuntary medication of the defendant is medically appropriate. The Ninth Circuit held that because the government failed to establish the facts necessary to satisfy all four prongs of the Sell test by clear and convincing evidence, the district court erred in authorizing the involuntary medication of the defendant

Promoting Sustainable Transportation with Campus Car Policies and Public Outreach

In fall of 2016 at California State University Monterey Bay (CSUMB), the Environmental Studies undergraduate program began offering its first group-based capstone course that was based on its first Projects for Sustainable City Year course (ENSTU 471). Capstone projects are a senior-level, project based graduation requirement for an undergraduate degree. The Sustainable City Year projects focused on increasing sustainable transportation at two locations; one in the nearby city of Salinas, California, and one on the CSUMB campus. A majority of the community in Salinas drive which has limited the quality and effectiveness of the shuttle system provided by Monterey-Salinas Transit (MST). Our group seeks to help increase ridership and promote sustainable transportation in this region. At CSUMB, traffic congestion on campus is increasingly problematic as the student body continues to row. The majority of students drive to campus in single passenger vehicles which increases the traffic on campus. Sustainable transportation via buses, bicycling, and carpooling helps decrease traffic congestion. In the following paper, the CSUMB project covers a proposed freshman vehicle restriction policy to encourage sustainable modes of transportation and a bus-bicycle culture. For the Salinas project, we worked directly with MST to encourage common knowledge of bus usage by creating an informational and interactive booklet

Transtorno específico de aprendizagem em crianças e adolescentes com transtorno bipolar : prevalência e correlatos neuroanatômicos

Objetivo: A presente pesquisa tem como objetivo estimar a prevalência do Transtorno Específico de Aprendizagem em crianças e adolescentes atendidos no Programa de Crianças e Adolescentes Bipolares (ProCAB) do Hospital de Clínicas de Porto Alegre e uma amostra da comunidade, avaliando as mudanças decorrentes das alterações nos sistemas classificatórios vigentes e identificar diferenças nas estruturas cerebrais de crianças e adolescentes com Transtorno Bipolar e Transtorno da Matemática comórbidos Método: Trata-se de um estudo transversal, em que foram avaliadas crianças e adolescentes (n=100) com idades entre 6 e 17 anos. Compuseram o grupo de casos crianças e adolescentes (n=60) com diagnóstico de Transtorno Bipolar atendidos no Programa de Crianças e Adolescentes Bipolares, ambulatório do hospital universitário da Universidade Federal do Rio Grande do Sul, Brasil. O grupo controle foi composto por crianças e adolescentes (n=40) de escolas públicas e privadas da cidade de Porto Alegre. Os participantes realizaram avaliação psiquiátrica, neuropsicológica e psicopedagógica. Os resultados foram primeiramente classificados com os critérios do DSM-IV e posteriormente os do DSM-5. Os níveis de concordância foram calculados. No estudo de neuroimagem funcional, participaram crianças e adolescentes (n=29) atendidos no Programa de Crianças e Adolescentes Bipolares. O grupo de casos foi composto por participantes (n=10) que apresentavam Transtorno Bipolar e Transtorno da Matemática comórbidos. O grupo controle foi composto por participantes (n=19) que tinham diagnóstico de TB apenas. As imagens de ressonância magnética e DTI foram adquiridas no scanner de corpo inteiro de 1.5 T Philips Achieva no Hospital de Clínicas de Porto Alegre, com uso de bobina de crânio de oito canais para recepção do sinal. Resultados: Encontramos prevalência de 45% de Transtorno Aprendizagem no grupo com TB e 10% no grupo controle de acordo com a DSM-IV; 58% de Transtorno Específico de Aprendizagem no grupo com TB e 13 % no grupo controle de acordo com o DSM-5. Os resultados indicam um aumento de 28.8% (p0.2), left cingulum-cingulate gyrus (p>0.38). We observed a significant difference between groups in the volume of the right cingulum-cingulate gyrus (p=0.01), but not in the FA (p=0.75), No significant difference was detected in the volume of the left superior longitudinal fasciculus-temporal terminations (p=0.14), but a trend for its FA was observed (p=0.07). We found a significant difference in both volume (p=0.001) and FA (p=0.04) in the left superior longitudinal fascículos parietal terminations. The subjects with BD and Mathematics Disorder presented a smaller volume, and a higher fractional anisotropy than the groups with BD alone. Conclusions: High rates of LD are observed in youth with BD, independently of the comorbidity of with ADHD. The proposed changes in the SLD diagnostic criteria with DSM-5 led to significantly increased SLD prevalence rates. Assessment of learning disorders should be part of the standardized evaluation of bipolar disorders in children and adolescents. Functional Neuroimaging indicated that subjects with Bipolar Disorder and Mathematics Disorder has lower volumes and higher fractional anisotropy in the left superior longitudinal fasciculus parietal terminations, suggesting abnormal myelination, microscopic deficits of axonal 10 structures or decreases in axonal diameter, packing density, and branching in these bundles

Comparación de criterios de síndrome metabólico en pacientes pediátricos con normopeso, sobrepeso y obesidad

"En cuanto a la prevalencia del síndrome metabólico, se han observado diferentes propuestas con el objetivo de poder captar a la mayor cantidad de pacientes con probable riesgo cardiovascular. Sin embargo, la prevalencia puede ser muy diferente secundario a que cada definición tiene distinto punto de corte para las diferentes variables del síndrome metabólico. Debido a la discrepancia en la prevalencia del síndrome metabólico se buscará comparar los diferentes criterios de síndrome metabólico para poder evaluar cuál es la herramienta con mayor capacidad de captar pacientes con síndrome metabólico en los tres estados nutricionales: normopeso, sobrepeso y obesidad. Se debe continuar estudiando esta población para poder detectar oportunamente a pacientes con riesgo cardiovascular para poder realizar intervenciones en salud antes que desarrollen consecuencias a nivel de micro y macrovasculatura. Este estudio aportará una visión en cuanto a la comparación de las distintas definiciones de síndrome metabólico en una población más amplia de edad, a diferencia de otros estudios que no lo han hecho.

Tratamientos primarios para garantizar la calidad del agua de consumo en poblaciones rurales de 1000, 2000 y 3000 habitantes. Evaluación del impacto ambiental.

This project seeks to provide an alternative degree economically cheap and friendly to the environment, in order to increase water quality standards for human consumption in rural populations in 1000, 2000 and 3000 inhabitants in Ecuador, thus avoiding number of infectious diseases, seeking the welfare of the population and a healthy lifestyle that allows the normal evolutionary development of its people, especially children, since water being a vital element, resulting in overall living conditions and promising future not only in rural communities but the entire country.El presente proyecto de titulación busca dar una alternativa económicamente barata y amigable con el medio ambiente, con la finalidad de incrementar los estándares de calidad del agua destinada al consumo humano en poblaciones rurales de 1000, 2000 y 3000 habitantes en el Ecuador, evitando así un sinnúmero de enfermedades infecto contagiosas, procurando el bienestar de la población y una vida saludable que permita el normal desarrollo evolutivo de sus habitantes, en especial de los niños, ya que el agua al ser un elemento vital, redunda en las condiciones generales de vida y en el futuro promisorio no solo de las comunidades rurales sino del país entero

Propuesta de mejora del grado de satisfacción de los clientes y de los procesos de servicios de inspección industrial e hidircarburífero: caso empresa Veripet Cia. Ltda

El objetivo de la presente propuesta metodológica es identificar técnicas adecuadas y específicas para incrementar la venta de los servicios industriales e hidrocarburíferos que brinda la compañía Veripet Cia. Ltda., para lo cual es imprescindible conocer la condición y relación actual de esta organización con sus clientes. Para saber de una forma más detallada la relación de cliente-empresa, se propone desarrollar un análisis del nivel de satisfacción de los clientes de esta compañía, mediante la aplicación del modelo SERVQUAL, y según los resultados que se obtengan al aplicar este modelo, proceder a proponer mejoras en los procesos de los servicios brindados. El modelo SERVQUAL implica llevar a cabo encuestas dirigidas a clientes, abordando preguntas que buscan conocer su nivel de satisfacción con los servicios que han recibido por parte de la empresa Veripet, cuando las encuestas fueron culminadas, se procedió a tabular los resultados, analizarlos y estos fueron útiles para proponer a la organización un Plan de Acción bastante consolidado y rentable, mismo que consta de once ítems enfocados como propuestas a corto plazo. Este Plan de Acción fue entregado a la alta gerencia de la compañía en mención y puesto a su consideración, quienes gerencialmente decidieron implementar el 72,72% del total de este Plan de Acción. Una vez, el Plan de Acción fue desarrollado e implementado dentro de la empresa, se volvió a encuestar por segunda vez a clientes para conocer el impacto en su grado de satisfacción, para obtener este dato se desarrolló un estudio estadístico llamado análisis de correlación, el cual indica si la variable -satisfacción del cliente- se modifica a medida que la variable -mejora de procesos de los servicios- cambia. El planteamiento y ejecución de la presente propuesta metodológica ayudó a confirmar que en efecto si es posible aumentar la satisfacción de los clientes, a medida que se mejoran los procesos de los servicios, por tal razón se concluye que esta correlación denota positivamente en el aumento de ingresos para la compañía de servicios Veripet Cía. Ltda.The objective of this methodological proposal is to identify suitable and specific techniques to increase the sales of industrial and hydrocarbon services provided by the company Veripet. To Achieve this, it is essential to understand the current condition and relationship of this organization with its clients. To gain a more detailed understanding of the client-company relationship, it is proposed to develop an analysis of the level of customer satisfaction with the company`s services, using the SERVQUAL model. Based on the results obtained from applying this model, improvements in the service processes can be proposed. The SERVQUAL model involves surveys directed at clients, addressing questions than aim to assess their level of satisfaction with services received from Veripet. Once the surveys were completed, the results were tabulated and analyzed. These results were useful in proposing a well-consolidated and profitable Action Plan consisting of eleven items focused on short-term proposals. This Action Plan was delivered to the senior management of the company for their consideration, and they decide to implement 72.72% of the total Action Plan. Once the Action Plan was developed and implemented within the company, a second survey was conducted to assess its impact on customer satisfaction. To obtain this data, a statistical study called correlation analysis was conducted, which indicates whether the variable “customer satisfaction” changes as the variable “service process improvements” change. The formulation and execution of this methodological proposal helped confirm that it is indeed possible to increase customer satisfaction as the service processes improve. Therefore, it can be concluded that this correlation positively contributes to increased revenue for the Veripet services company

Pelvic Organ Distribution of Mesenchymal Stem Cells Injected Intravenously after Simulated Childbirth Injury in Female Rats

The local route of stem cell administration utilized presently in clinical trials for stress incontinence may not take full advantage of the capabilities of these cells. The goal of this study was to evaluate if intravenously injected mesenchymal stem cells (MSCs) home to pelvic organs after simulated childbirth injury in a rat model. Female rats underwent either vaginal distension (VD) or sham VD. All rats received 2 million GFP-labeled MSCs intravenously 1 hour after injury. Four or 10 days later pelvic organs and muscles were imaged for visualization of GFP-positive cells. Significantly more MSCs home to the urethra, vagina, rectum, and levator ani muscle 4 days after VD than after sham VD. MSCs were present 10 days after injection but GFP intensity had decreased. This study provides basic science evidence that intravenous administration of MSCs could provide an effective route for cell-based therapy to facilitate repair after injury and treat stress incontinence