Estrategias para compensar las habilidades adaptativas de una persona con TCE en su núcleo familiar

Aquest treball inclou el disseny i l'elaboració d'un projecte titulat

Brote de brucelosis interprovincial por ingesta de queso fresco sin higienizar

Goal: To study an August 2004 outbreak of brucellosis notified in Velez-Rubio (Almeria) and to determine the source of that infection as well as its transmission mechanisms, in addition to proposing preventive measures. Methodology: Descriptive study and paired case controls (three controls were selected for each case). Setting: Health Centers in de Vélez-Rubio (Almeria) and Alcalá de Guadaira (Seville). Population: Suspected/probable case: a person with compatible clinical symptoms and positive brusella agglutination diagnosed between July 2005 and March 2005. Confirmed case: in addition to identifying the causal agent, laboratory test results resulted in a confirmation. Interventions: Report forms, epidemiological surveys, clinical histories, and laboratory tests were used as sources of data. Odds ratios (OR) and confidence intervals were calculated to study the relationship among cases, sources of infection, and transmission mechanisms. The Chi Square test and Yates correction were employed. Results: 10 cases were identified (9 in Almeria and 1 in Seville), 8 of them pobable and 2 confirmed, in persons between the ages of 45 and 81. The symptoms first appeared between the months of May and September 2005. Fever was the most frequent symptom (100%). The OR for the consumption of fresh, non.-pasteurized cheese was 112 (CI 4,48-16968,94), p< 0,001. Infected animals were intervened. Conclusions: The inter-provincial outbreak of brucellosis was confirmed as stemming from the consumption of non-pasteurized cheese sold on the street. The source of infection was identified and the Department of Agriculture carried out the necessary actions.

Use of DNA profiles for investigation using a simulated national DNA database: Part II. Statistical and ethical considerations on familial searching.

Familial searching consists of searching for a full profile left at a crime scene in a National DNA Database (NDNAD). In this paper we are interested in the circumstance where no full match is returned, but a partial match is found between a database member's profile and the crime stain. Because close relatives share more of their DNA than unrelated persons, this partial match may indicate that the crime stain was left by a close relative of the person with whom the partial match was found. This approach has successfully solved important crimes in the UK and the USA. In a previous paper, a model, which takes into account substructure and siblings, was used to simulate a NDNAD. In this paper, we have used this model to test the usefulness of familial searching and offer guidelines for pre-assessment of the cases based on the likelihood ratio. Siblings of "persons" present in the simulated Swiss NDNAD were created. These profiles (N=10,000) were used as traces and were then compared to the whole database (N=100,000). The statistical results obtained show that the technique has great potential confirming the findings of previous studies. However, effectiveness of the technique is only one part of the story. Familial searching has juridical and ethical aspects that should not be ignored. In Switzerland for example, there are no specific guidelines to the legality or otherwise of familial searching. This article both presents statistical results, and addresses criminological and civil liberties aspects to take into account risks and benefits of familial searching.

Research involving biological material from forensic autopsies: legal and ethical issues.

Recommendations and laws do not always contain specific and clear provisions on the use of cadaveric material in research, and even more rarely do they address explicitly the ethical issues related to research on material obtained during forensic autopsy. In this article we analyse existing legal frameworks in Europe by comparing the legal provisions in 2 European Countries which are member states of the Council of Europe, the UK and Switzerland. They were chosen because they have distinct legal frameworks that make comparisons interesting. In addition, the detailed laws of the UK and a specific law project and national ethical recommendations in Switzerland permit us to define more clearly the legal range of options for researchers using cadaveric material obtained during forensic investigations. The Human Tissue Act 2004 in England, Wales and Northern Ireland, its Scottish equivalent with the same title (2006) and the national ethical guidelines in Switzerland all require consent from the deceased person, an appropriate relative or a person with power of attorney for healthcare decisions before cadaveric biological material can be obtained and used for research. However, if the purpose of the autopsy is purely forensic, no such authorization will be sought to carry out the autopsy and related analyses, which might include genetic testing. In order to be allowed to carry out future research projects, families need to be approached for informed consent, unless the deceased person had left written directives including permission to use his or her tissues for research.

Affirmative Action in Iowa, September 2007

In accordance with 19B.5 of the Code of Iowa, the 2007 Affirmative Action in Iowa report illustrates the progress made during fiscal year 2007 to balance the State's workforce, the challenges that the State must address and the effort that the Department of Administrative Services must lead in order to remove barriers that limit the hiring, retention and advancement of females, minorities and persons with disabilities in the State's workforce. Highlighted in the report are the State's efforts to improve EEO/AA/Diversity training, coordinating targeted recruitment and partnering with disability organizations. Additionally, the Department of Administrative Services-Human Resources Enterprise outlines its plan to build on its past efforts and implement recommendations to remove barriers in the state selection processes and to improve its affirmative action and auditing processes.

Mobile phone use and brain tumors in children and adolescents: a multicenter case-control study.

Background It has been hypothesized that children and adolescents might be more vulnerable to possible health effects from mobile phone exposure than adults. We investigated whether mobile phone use is associated with brain tumor risk among children and adolescents. Methods CEFALO is a multicenter case-control study conducted in Denmark, Sweden, Norway, and Switzerland that includes all children and adolescents aged 7-19 years who were diagnosed with a brain tumor between 2004 and 2008. We conducted interviews, in person, with 352 case patients (participation rate: 83%) and 646 control subjects (participation rate: 71%) and their parents. Control subjects were randomly selected from population registries and matched by age, sex, and geographical region. We asked about mobile phone use and included mobile phone operator records when available. Odds ratios (ORs) for brain tumor risk and 95% confidence intervals (CIs) were calculated using conditional logistic regression models. Results Regular users of mobile phones were not statistically significantly more likely to have been diagnosed with brain tumors compared with nonusers (OR = 1.36; 95% CI = 0.92 to 2.02). Children who started to use mobile phones at least 5 years ago were not at increased risk compared with those who had never regularly used mobile phones (OR = 1.26, 95% CI = 0.70 to 2.28). In a subset of study participants for whom operator recorded data were available, brain tumor risk was related to the time elapsed since the mobile phone subscription was started but not to amount of use. No increased risk of brain tumors was observed for brain areas receiving the highest amount of exposure. Conclusion The absence of an exposure-response relationship either in terms of the amount of mobile phone use or by localization of the brain tumor argues against a causal association.

Collaboration entre médecin de famille et psychiatre pour les problèmes de santé mentale [Family physicians and psychiatrists' collaborative care for mental health problems].

The burden of disease linked to mental disorders represents more than one-fifth of years lived with disability in the world. Less than half of people suffering from mental disorders are adequately treated. Three quarter of those who receive treatment are followed by primary care. Collaborative care aims to increase the efficiency of direct general practitioner's treatment. Main components are sustainable and individualized consultation-liaison relationship (1/2 day of psychiatrist by 15 days for 10-15 general practitioners), and support of a clinical case manager for complex situations. Collaboration is bidirectional: early or crisis access to specialist care and long-term followup by general practitioner. This model is a challenge for the doctor-patient dual relationship and requires incentives in a public health perspective.

Experiències poètiques de qualitat a la infància

La poesia és un gènere literari, massa sovint, oblidat a les escoles. No obstant, està demostrat que es pot treballar amb persones de totes les edats, des d’infants ben petits, fins a persones adultes, sempre i quan, les metodologies i les tècniques utilitzades siguin adequades als receptors. Aquest gènere no implica només comprensió del vocabulari i del missatge final, sinó també comporta gaudir del joc de les paraules, dels sons, de la melodia, del ritme... Es pot dir, doncs, que poesia i música, són dues arts que estan estretament relacionades. Quins elements provoquen que una experiència de poesia tingui qualitat? En primer lloc, el “què”, quin tipus de poesia oferim als infants. Així doncs, els podem proporcionar poesia escrita per a infants, però també poesia , en un inici, pensada per a adults. I és que el poema que és bo per a nens/es també ho és per a gent més gran, i a l’inrevés. A més a més, la poesia ha de ser rítmica, melòdica i que busqui constantment el joc sonor de les paraules. En segon lloc, el “qui”, és a dir, quines condicions ha de tenir la persona que escriu i recita poesia, per fer-ho amb la màxima qualitat possible. L’escriptor ha de ser una persona culta, amb un profund lligam artístic. No tothom serveix per a ser un bon escriptor, ja que comporta una gran tasca . Pel que fa a l’art de recitar, és una habilitat que tothom pot adquirir, amb pràctica, voluntat i constància. En tercer i últim lloc, el “com”, la metodologia adequada per presentar la poesia als infants. Aquest gènere literari s’ha de presentar de forma vivencial. El primer que han de fer els infants és estar en contacte amb la llengua i viure la poesia. Només així aprendran a estimar aquest gènere i a creure en ell i en les seves possibilitats.

Evaluation of Lightweight Profilers for Construction Smoothness Evaluation, MLR-02-02, 2004

High-speed non-contact laser profilers have become the standard testing equipment for pavement management ride quality testing. The same technology used in the high-speed profilers is now being used in lightweight profilers for construction smoothness testing. The lightweight profilers have many advantages over the California 25-ft profilograph. Despite the many advantages of the lightweight profilers, there is resistance from the contracting industry toward eliminating the 25-ft profilograph for construction ride testing. One way to reduce or overcome the resistance is to evaluate and demonstrate the advantages/disadvantages of the lightweight profiler in actual field use in Iowa. The objective of the study was to purchase a lightweight profiler and to evaluate its suitability for construction smoothness quality verification and quality acceptance on Iowa projects. A lightweight profiler, an Ames Engineering, Inc. LISA single laser unit, was received in February 2003 for the study. Based on the work done during the 2003 construction season, the following conclusions can be made: (1) For hot mix asphalt surfaces, the LISA correlated well with the contractors' profilographs; (2) LISA results are significantly affected by longitudinal tining on portland cement concrete pavements, requiring a laser system upgrade to give accurate results; (3) A significant timesaving was realized by using the LISA; (4) Increasing visibility and reducing time in the construction zone improved safety; (5) One person with limited lifting capabilities could set up and operate the LISA; and (6) With the current Iowa Department of Transportation specification, the LISA cannot totally replace the profilograph, since bridges and short segments with no adjoining pavement would still require a profilograph.

Voiko dementiaoireisen henkilön ajan orientaatiota tukea apuvälineen avulla?

Abstract: Can the time orientation of a person with dementia be improved by an assistive aid?

Dementoituvan ihmisen oikeudellinen toimintakyky ja sen lääketieteellinen arviointi

English summary: Legal capacity of a person with dementia and its medical assessment (s. 1084-1085)

Holhoustoimen edunvalvontapalvelut, kiinteistön kauppa ja panttaus

Tutkielman tarkoituksena on antaa kokonaiskuva kiinteistön kauppaan ja panttaukseen liittyvistä menettelyistä, kun oikeustoimen osapuolena on henkilö, jolla on holhoustoimilain mukainen edunvalvoja. Tutkielmassa kuvataan edunvalvojan ja edunvalvojan sijaisen määräämis- menettelyä sekä menettelyä koskien holhousviranomaisen luvan vaativia kiinteistön kauppoja ja panttauksia. Kuvaus perustuu pääosin lakien säännöksiin ja niiden esitöihin, olemassa oleviin kirjallisiin lähteisiin ja korkeimman oikeuden ennakkoratkaisuihin.

La mejora de la calidad de vida de las personas con lesión medular: la transición del centro rehabilitador a la vida cotidiana desde la perspectiva de los usuarios

El retorno a la vida cotidiana para una persona con lesión medular después del periodo de rehabilitación en régimen hospitalario, es un proceso difícil no exento de dificultades y nuevos retos personales. En este trabajo nos planteamos identificar aquellos factores más relevantes que contribuyen a mejorar su calidad de vida, desde la perspectiva de las propias personas afectadas. Hemos realizado dos grupos de discusión: uno formado por 12 personas con paraplejia y otro formado por 6 personas con tetraplejia. El análisis de contenido realizado indica que, para los participantes existen dos dimensiones relacionadas con su percepción de calidad de vida una vez salen del centro de rehabilitación: a) necesidad de atención al entorno más próximo y b) preparación para el mundo real. Concluimos señalando la importancia de realizar programas de rehabilitación integral, que incluyan, rehabilitación física, aprendizaje de habilidades que posibiliten el máximo de independencia y autonomía personal y trabajo de apoyo a la familia

Perceptions of Alzheimer's Disease in the French Population : Evolutions between 2008 and 2013 and Associated Factors in 2013

Abstract: Background. The negative image surrounding AD has a substantial impact on caregiving and on those affected by the disease. Opinion surveys was created as part of the 2008-2012 Alzheimer Plan in France, which included two surveys in general population, at the beginning and at the end. Objective. To evaluate changes of the French population in perceptions, knowledge and beliefs since 5 years and to analyze dimensions with sociodemographics criteria and proximity with AD. Methods. After selection by quota sampling, 2013 French people aged 18 years and over were interviewed by phone in 2008 and 2509 in 2013. Chi-squared tests were carried out to measure the changes between two periods and multivariate logistics regressions were used to assess perceptions. Results. People who cited AD as one of the three most serious diseases increased in 2013 (33.6% versus 26.7% in 2008; p < 0.001). There was no significant change as regards the fear, the sense of being informed and the feeling of embarrassment. Opinions "there are treatments available to improve the wellbeing of patients" and "it is normal to suffer memory loss as you get older" decreased in 2013. Close family carers had a greater sense of the seriousness, a higher risk perception, a better sense of being informed and a greater ease in the presence of a person with AD. Conclusions. The results serve as indicators of the effects of the Alzheimer Plan on French society and testify to the rather weak impact of the Plan on public opinion.

The importance of distinguishing information from evidence/observations when formulating propositions

The value of forensic results crucially depends on the propositions and the information under which they are evaluated. For example, if a full single DNA profile for a contemporary marker system matching the profile of Mr A is assessed, given the propositions that the DNA came from Mr A and given it came from an unknown person, the strength of evidence can be overwhelming (e.g., in the order of a billion). In contrast, if we assess the same result given that the DNA came from Mr A and given it came from his twin brother (i.e., a person with the same DNA profile), the strength of evidence will be 1, and therefore neutral, unhelpful and irrelevant 1 to the case at hand. While this understanding is probably uncontroversial and obvious to most, if not all practitioners dealing with DNA evidence, the practical precept of not specifying an alternative source with the same characteristics as the one considered under the first proposition may be much less clear in other circumstances. During discussions with colleagues and trainees, cases have come to our attention where forensic scientists have difficulty with the formulation of propositions. It is particularly common to observe that results (e.g., observations) are included in the propositions, whereas-as argued throughout this note-they should not be. A typical example could be a case where a shoe-mark with a logo and the general pattern characteristics of a Nike Air Jordan shoe is found at the scene of a crime. A Nike Air Jordan shoe is then seized at Mr A's house and control prints of this shoe compared to the mark. The results (e.g., a trace with this general pattern and acquired characteristics corresponding to the sole of Mr A's shoe) are then evaluated given the propositions 'The mark was left by Mr A's Nike Air Jordan shoe-sole' and 'The mark was left by an unknown Nike Air Jordan shoe'. As a consequence, the footwear examiner will not evaluate part of the observations (i.e., the mark presents the general pattern of a Nike Air Jordan) whereas they can be highly informative. Such examples can be found in all forensic disciplines. In this article, we present a few such examples and discuss aspects that will help forensic scientists with the formulation of propositions. In particular, we emphasise on the usefulness of notation to distinguish results that forensic scientists should evaluate from case information that the Court will evaluate.