The Careers of Two Ritas: Latinas, Hollywood, and the Dilemmas of Anglicization

Senior capstone project for AMST 450.

Screening of esophageal varices by esophageal capsule endoscopy: results of a French multicenter prospective study

International audience

Councellors' Experience During Training and Home Based HIV Councelling and Testing in Zomba District, Malawi

Introduction In 2007, St Luke’s Mission Hospital initiated a district-wide Door to Door HIV counselling and testing (HCT) programme in Zomba district. The intent of the programme was to provide quality HCT services to people in their homes and effectively those found to be HIV positive referred to appropriate services. Methodology This was a cross sectional study using a questionnaire consecutively administered to a sample of 105 counsellors who had resided in the community for a period of over one year. The questionnaire sought to establish, knowledge gained, experiences and recommendations on how the programme has been implemented and assist running of similar future programmes. Data analysis was done manually using both qualitative and quantitative methodologies. Results We report that nearly 23% of the counsellors thought that during their training as a door to door HTC councelor they had benefited in learning to working with communities; an aspect they found to be highly applicable in discharge of their duties. The major setbacks during the training were lack daily allowances, less amount of time spent on understanding child councelling and the manual used was diffucult to follow. Over 32% of the councellors were satisfied with the participation of their clients during pre-test counselling sessions, however, the major challenge they had was the misconception that they were blood suckers, a view reported by nearly 17% of the counsellors. Close to 72% reported not to have met any problems during post-test counselling compared to 24% who reported to have found challenges. Conclusion The study has revealed that there is a need to re-look child children counselling especially in training door to door HCT counsellors. It has also revealed the prevalent allowance culture despite the benefits of training. The common challenges were refusal of test Results and failure to understand discordance. Misconceptions may still exist in the community regarding anything dealing with removing blood. There is still need for more information regarding discordance especially among couples in the community.

O olhar e a voz no autismo : da elisão do significante à possibilidade de enlace com o outro

Dissertação (mestrado)—Universidade de Brasília, Instituto de Psicologia, Departamento de Psicologia Clínica, Programa de Pós-Graduação em Psicologia Clínica e Cultura, 2015.

Pensamento de Remo Bodei sobre a filosofia do século XX : da estagnação ao retorno da responsabilidade

Dissertação (mestrado)—Universidade de Brasília,Instituto de Ciências Humanas, Programa de Pós-Graduação em Filosofia, 2014.

Conservative management in very elderly patients with severe aortic stenosis: Time to change?

Despite current recommendations, a high percentage of patients with severe symptomatic aortic stenosis are managed conservatively. The aim of this study was to study symptomatic patients undergoing conservative management from the IDEAS registry, describing their baseline clinical characteristics, mortality, and the causes according to the reason for conservative management. Consecutive patients with severe aortic stenosis diagnosed at 48 centers during January 2014 were included. Baseline clinical characteristics, echocardiographic data, Charlson index, and EuroSCORE-II were registered, including vital status and performance of valve intervention during one-year follow-up. For the purpose of this substudy we assessed symptomatic patients undergoing conservative management, including them in 5 groups according to the reason for performing conservative management [I: comorbidity/frailty (128, 43.8%); II: dementia 18 (6.2%); III: advanced age 34 (11.6%); IV: patients’ refusal 62 (21.2%); and V: other reasons 50 (17.1%)]. We included 292 patients aged 81.5 ± 9 years. Patients from group I had higher Charlson index (4 ± 2.3), higher EuroSCORE-II (7.5 ± 6), and a higher overall (42.2%) and non-cardiac mortality (16.4%) than the other groups. In contrast, patients from group III had fewer comorbidities, lower EuroSCORE-II (4 ± 2.5), and low overall (20.6%) and non-cardiac mortality (5.9%). Patients with severe symptomatic aortic stenosis managed conservatively have different baseline characteristics and clinical course according to the reason for performing conservative management. A prospective assessment of comorbidity and other geriatric syndromes might contribute to improve therapeutic strategy in this clinical setting.

La prise en compte du refus de services des personnes aînées par les travailleuses sociales en contexte de soutien à domicile.

Au Québec, comme partout dans les pays développés, le vieillissement de la population oblige à repenser les méthodes d’intervention (Couturier et al., 2013). De plus, vieillir chez soi en conservant la meilleure qualité de vie possible est un souhait cher à la majorité des personnes aînées (Mauriat et al., 2009). Pour prendre en considération ce souhait, malgré la complexité de la situation biopsychosociale de plusieurs, le système de santé et de services sociaux offre un service de soutien à domicile dans lequel des coordonnateurs dédiés (ex. : gestionnaires de cas, travailleuses sociales pivots) coordonnent les différents services requis afin de répondre aux besoins des personnes vivant à domicile avec une autonomie fonctionnelle diminuée (Couturier et al., 2013). Plusieurs personnes aînées en situation biopsychosociale complexe refusent les services offerts (Corvol et al., 2012). Ce refus peut aller de la simple décision de ne pas prendre sa médication ou de ne pas accepter l’aide à la toilette à celle de refuser l’aide alimentaire ou des soins et services essentiels, et, ce faisant, d’encourir d’importants risques quant à leur sécurité, voire leur survie (Balard et Somme, 2011). Au Québec, sauf dans les cas d’exception prévus par la loi, la liberté de consentir ou non à des soins est un droit reconnu à chaque personne, consacrant ainsi les principes d’intégrité et d’inviolabilité de la personne (gouvernement du Québec, n.d.). Le cadre professionnel des travailleuses sociales, via leur formation et les lignes directrices de l’Ordre des travailleurs sociaux et des thérapeutes conjugaux et familiaux du Québec (OTSTCFQ), favorise également l’autonomie de la personne à travers des approches visant l’empowerment. Cependant, les mêmes cadres leur donnent également un rôle central à jouer lorsqu’il est question de reconnaître l’inaptitude des personnes à décider pour elles-mêmes, notamment à travers l’acte d’évaluation psychosociale dans un tel contexte. Plus largement, la société donne plus ou moins formellement un mandat de protection des personnes vulnérables aux travailleuses sociales. Ce mandat de protection est au cœur de leur métier, mais il ne fait pas l’objet d’une reconnaissance légale forte, comme c’est le cas pour l’objet aptitude/inaptitude. Pour la réalisation de ce mémoire, 10 entretiens semi-directifs furent menés auprès de travailleuses sociales en soutien à domicile afin de nous permettre de comprendre comment les travailleuses sociales prennent en compte le refus de services des personnes aînées. Pour ce faire, nous répondons à quatre objectifs. Premièrement, nous dégageons le sens qu’accordent les travailleuses sociales au refus de services et la façon dont elles le reçoivent. Deuxièmement, nous décrivons les stratégies d’adaptation au refus des travailleuses sociales. Troisièmement, nous tentons de comprendre les liens entre le sens donné au refus de services et les stratégies d’adaptation des travailleuses sociales. Finalement, nous explorons comment les relations de pouvoir expliquent en partie ces adaptations. Cette recherche nous a permis de montrer que dans de nombreux cas, les stratégies impliquant une prise de pouvoir lors de situations de refus n’étaient pas légitimées par une volonté de faire vivre la personne le plus longtemps possible en la protégeant, mais plutôt par le discours valorisant son autonomie. Nous croyons que ce discours, en constante évolution, pourrait prendre de plus en plus de place dans les prochaines années et qu’en conséquence, si nous souhaitons que les modèles de prise de décision partagée (par exemple l’usager-partenaire) soient appliqués de la bonne façon, il est essentiel d’outiller les travailleuses sociales pour éviter que les personnes résistant au discours de l’autonomie soient perçues comme de mauvais usagers.

Diritto penale e questioni di fine vita: il suicidio assistito e l'eutanasia.

Il presente elaborato si propone di esaminare il tema del fine vita, con specifico riferimento al suicidio assistito e all’eutanasia. Dopo aver evidenziato la netta distinzione tra rifiuto/rinuncia del trattamento sanitario anche salva vita, aiuto al suicidio ed eutanasia, ci si sofferma, in primo luogo, sull’analisi della legge n. 219/2017, rubricata “Norme in materia di consenso informato e di disposizioni anticipate di trattamento”, che riconosce la massima ampiezza all’autodeterminazione terapeutica nell’ambito della relazione medico-paziente. In secondo luogo, si esamina il tema del suicidio assistito, soffermandosi sulle pronunce della giurisprudenza costituzionale e di merito. Successivamente, in una prospettiva comparata, viene fornita un’ampia analisi delle discipline della morte medicalmente assistita attualmente vigente in diversi ordinamenti. Infine, si esamina il tema dell’eutanasia, in particolare concentrandosi sulla donazione di organi post eutanasia, sul rischio della slippery slope e sulla necessità di tutelare i soggetti vulnerabili.

A phase II, single arm study of CarbopLatin plus Etoposide with Bevacizumab and Atezolizumab in patients with exTEnded-disease small-cell lung cancer (SCLC) – CeLEBrATE trial

Small cell lung cancer (SCLC) is an aggressive neuroendocrine tumor diagnosed at extended disease SCLC (ES-SCLC) stage in about 70% of cases. The new standard of treatment for patients with ES-SCLC is a combination of platinum-etoposide chemotherapy and atezolizumab or durvalumab, two programmed cell death ligand 1 (PD-L1) inhibitory monoclonal antibodies (mAb). However, the benefit derived from the addition of PD-L1 inhibitors to chemotherapy in ES-SCLC was limited and restricted to a subset of patients. The vascular endothelial growth factor (VEGF) is the most important pro-angiogenic factor implicated in cancer angiogenesis, which is abundant in SCLC and associated with poor prognosis. Antiangiogenic agents, such as bevacizumab, a humanized mAb against VEGF, added to platinum-etoposide chemotherapy improved progression-free survival in SCLC in two trials, but it did not translate into a benefit in overall survival. Nevertheless, VEGF has also acts as a mediator of an immunosuppressive microenvironment and its inhibition can revert the immune-suppressive tumor microenvironment and potentially enhance the efficacy of immunotherapies. Based on available preclinical data, we hypothesized that VEGF inhibition by bevacizumab could improve atezolizumab efficacy in a synergistic way and designed a phase II single-arm trial of bevacizumab in combination with carboplatin, etoposide, and atezolizumab as first-line treatment in ES-SCLC. The trial, which is still ongoing, enrolled 53 patients, including those with treated or untreated asymptomatic brain metastases (provided criteria are met), who received atezolizumab, bevacizumab, carboplatin and etoposide for 4-6 cycles (induction phase), followed by maintenance with atezolizumab and bevacizumab for a maximum of 18 total cycles or until disease progression, patient refusal, unacceptable toxicity. The evaluation of efficacy of the experimental combination in terms of 1-year overall survival rate is not yet mature (primary objective of the trial). The combination was feasible and the toxicity profile manageable (secondary objective of the trial).

Grassezza e obesità nei giornali italiani: una questione di rappresentazioni

Our contemporary society still sees the fat body as a problematic issue. This refusal originated as a racist control practice and developed as an esthetical and medical problem, resulting in the stigmatization and discrimination of this marginalized social group. Drawing on a corpus of about 157,000 words, the present study aims to shed light on how journalistic language might play a role in reinforcing prejudices towards fat people and, consequently, their stigmatization. The corpus contains 305 articles on fatness and/or obesity that were taken from six Italian newspapers representing different political leanings. The analysis is based on three main research questions: which frames are used to represent fat people in Italian newspapers? Do women get a particular treatment when talked about in relation to fatness/obesity? Do the articles employ any stigmatizing discourse strategies? Results show particular emphasis on the medical aspects of fatness/obesity, in terms of consequences on fat people’s health due to their lifestyle choices, with little to no consideration of societal responsibility around weight stigma. There is also evidence of women being talked about more than men in connection with this topic, especially with regards to their duty to appear in a certain way and their responsibility as mothers. Furthermore, articles display a vast amount of stigmatizing discourses, that go from offensive referential and predicational strategies, to an explicit mockery of fat people. In conclusion, the journalistic discourses on fatness/obesity analyzed in the present study show problematic traits possibly affecting fat people’s quality of life and should be examined more extensively as to establish a generalizing pattern by taking a larger set of data into account.