How family caregivers' medical and moral assumptions influence decision making for patients in the vegetative state: a qualitative interview study.

Background Decisions on limiting life-sustaining treatment for patients in the vegetative state (VS) are emotionally and morally challenging. In Germany, doctors have to discuss, together with the legal surrogate (often a family member), whether the proposed treatment is in accordance with the patient's will. However, it is unknown whether family members of the patient in the VS actually base their decisions on the patient's wishes. Objective To examine the role of advance directives, orally expressed wishes, or the presumed will of patients in a VS for family caregivers' decisions on life-sustaining treatment. Methods and sample A qualitative interview study with 14 next of kin of patients in a VS in a long-term care setting was conducted; 13 participants were the patient's legal surrogates. Interviews were analysed according to qualitative content analysis. Results The majority of family caregivers said that they were aware of aforementioned wishes of the patient that could be applied to the VS condition, but did not base their decisions primarily on these wishes. They gave three reasons for this: (a) the expectation of clinical improvement, (b) the caregivers' definition of life-sustaining treatments and (c) the moral obligation not to harm the patient. If the patient's wishes were not known or not revealed, the caregivers interpreted a will to live into the patient's survival and non-verbal behaviour. Conclusions Whether or not prior treatment wishes of patients in a VS are respected depends on their applicability, and also on the medical assumptions and moral attitudes of the surrogates. We recommend repeated communication, support for the caregivers and advance care planning.

La médecine de famille en Suisse à l'horizon 2030: quelle place pour la délégation des tâches médicales. [Family practitioners in Switzerland by 2030: which roles for medical task delegation?]

Due to population aging, by 2030 Switzerland may face a demand of 24 million family practitioner visits, a growth of 13 percent from the 2005 level. This result is based on the assumption that the per capita demand for doctor visits remains what was observed in 2005 by age groups and sex. During the same period, the total number of practitioners may decrease by 14 percent whereas the female proportion of such practitioners may double. These changes may cause a 33 percent decrease in the supply of physician visits to reach only 14 millions. The comparison of the demand and supply of family doctor visits reveals that by 2030, 10 million visits may be unmet which represents 40 percent of the demand. On the supply side, a full scale implementation of task delegation may partially reduce that gap (minus 2 millions). On the demand side, improved health status may bring in a larger decrease in the needs for visits (minus 4 million).

Screening of the antimalarial activity of plants of the Cucurbitaceae family

Crude ethanolic extracts (CEEs) from two species of Cucurbitaceae, Cucurbita maxima and Momordica charantia (commonly called "abóbora moranga" and melão de São Caetano", respectively) were assayed for antimalarial activity by the 4-d suppressive test. The CEE of dry C. maxima seeds showed strong antimalarial activity following oral administration (259 and 500 mg/kg), reducing by 50% the levels of parasistemia in Plasmodium berghey-infected mice. Treatment of normal animals with 500 mg/Kg of the extract three days before intravenous injection of P. berghei caused a significant 30% reduction in parasitemic levels. No effect was observed when the animals were treated with the CEE only on the day of inoculation. Oral administration of the CEE of dry M. charantia leaves adminstered orally was ineffective up to 500 mg/Kg in lowering the parasitemic levels of malarious mice.

Kudoa sciaenae (Myxozoa: Multivalvulidae) cysts distribution in the somatic muscles of Stellifer minor (Tschudi, 1844) (Pisces: Sciaenidae)

The distribution of Kudoa sciaenae cysts (Myxozoa), in terms of intensity and prevalence, in the somatic muscles of the sciaenid Stellifer minor, shows an apparent preference for the anterior body region, including the head. The observed preference seems to be a consequence of the differential distribution of muscle mass, in the defined area, because when density (cyst/g dry muscle), is considered, all the somatic areas, but not cephalic area, do no show significant differences in terms of mean intensity and prevalence.

Family physician involvement in cancer care and lung cancer patient emotional distress and quality of life.

PURPOSE: This study aims to describe emotional distress and quality of life (QoL) of patients at different phases of their lung cancer and the association with their family physician (FP) involvement. METHODS: A prospective study on patients with lung cancer was conducted in three regions of Quebec, Canada. Patients completed, at baseline, several validated questionnaires regarding their psychosocial characteristics and their perceived level of FP involvement. Emotional distress [profile of mood states (POMS)] and QoL [European Organization for Research and Treatment of Cancer Quality of Life Core 30 (EORTC QLQ-C30)] were reassessed every 3-6 months, whether patients had metastasis or not, up to 18 months. Results were regrouped according to cancer phase. Mixed models with repeated measurements were performed to identify variation in distress and QoL. RESULTS: In this cohort of 395 patients, distress was low at diagnosis (0.79 ± 0.7 on a 0-4 scale), raising to 1.36 ± 0.8 at the advance phase (p < 0.0001). Patient's global QoL scores significantly decreased from the diagnosis to the advance phase (from 66 to 45 on a 0-100 scale; p < 0.0001). At all phases of cancer, FP involvement was significantly associated with patients' distress (p = 0.0004) and their global perception of QoL (p = 0.0080). These associations remained statistically significant even after controlling for age, gender, and presence of metastases. CONCLUSIONS: This study provides new knowledge on patients' emotional distress and QoL with cancer evolution and, particularly, their association with FP involvement. Other studies should be conducted to further explore FP role in cancer supportive care.

La paletina: un pinzell pla i prim

Treball de recerca realitzat per una alumna d'ensenyament secundari i guardonat amb un Premi CIRIT per fomentar l'esperit científic del Jovent l'any 2009. L’origen de l’autora és la Sénia, un poble d'uns 6000 habitants de la província de Tarragona, on, tot i el predomini actual de la fabricació de mobles, les primeres mostres d'industrialització foren el paper i els pinzells. L’arrelament de la indústria pinzellera de la seva família, ha estat el motiu que l’ha portat a desenvolupar aquest treball sobre la paletina, un tipus de pinzell. L'objectiu del treball ha estat dissenyar un model de paletina, a partir de proves pràctiques i d'estudis estadístics sobre quins són els components més adients. En primer lloc, es fa una descripció detallada dels components de la paletina. A continuació, s’estudia el seu procés de fabricació, primer des del punt de vista manual i després d'acord amb els procediments moderns. Finalment, a partir d'un experiment i amb el corresponent estudi estadístic, s’arriba a una nova proposta de paletina amb unes condicions òptimes de qualitat i rendiment. A més també es descriu el procés de fabricació de la paletina que es duia a terme uns cinquanta anys enrere i es pot valorar, així, tant el mèrit del procés en aquella època com també l'evolució tecnològica que s'ha dut a terme fins al moment.

On some family related parasites (Nematoda, Cucullanidae) from the marine fish Paralonchurus brasiliensis (Steindachner, 1875) (Pisces, Ostraciidae)

Dichelyne (Cucullanellus) elongatus (Tornquist, 1931) Petter, 1974 and Cucullanus pulcherrimus Barreto, 1918, from Paralonchurus brasiliensis (Steind., 1875) are redescribed and two specimens of Dichelyne (Cucullanellus) sp. are also reported in this host, despite lack of previously, was again identified in Brazil since its original description and posterior illustration. The present findings represent also a new host record for the referred genera: Dichelyne Jagerskiold, 1902 and Cucullanus Mueller, 1777. D. (C.) elongatus is also referred in Brazil for the first time.

Avantpassats de plata

Treball de recerca realitzat per una alumna d'ensenyament secundari i guardonat amb un Premi CIRIT per fomentar l'esperit científic del Jovent l'any 2009. El treball es centra en conèixer la complexitat d’un estudi fotogràfic del s. XIX: l’estudi Napoleón. Per entendre tots els aspectes que implicava fer una fotografia en aquest estudi comença explicant com es van desenvolupar i descobrir les diferents tècniques fotogràfiques, després presenta l’estat de la fotografia a la Catalunya del s. XIX. El nucli del treball té diferents aspectes: per una banda s’investiga la història dels fundadors d’un dels estudis més importants a la Barcelona del s. XIX, per l’altra presenta com eren les sales, els decorats, els clients, la tipografia, les càmeres .... i per últim, porta a la pràctica tot allò necessari per a transformar un paper blanc en una fotografia fent servir els mètodes de l’època. Podríem dir que el treball es desenvolupa en tres àmbits: el primer sobre els fonaments tècnics i històrics de la fotografia, les fonts utilitzades per realitzar aquest apartat han estat fonamentalment bibliogràfiques; el segon fa referència a l’estudi fotogràfic dels Napoleón, en aquest cas, a part de les fonts bibliogràfiques, també ha estat de vital importància la informació aportada per un descendent de la família i finalment s’explica els procediments que es van fer servir per obtenir imatges durant el segle s.XIX i les reaccions químiques en les quals es fonamenten. Aporta també una part experimental que dóna un caire artístic i novedós al treball.

Delinquency in male adolescents: the role of alexithymia and family structure

The purpose of this study was to examine the linkages between alexithymia and delinquency in male adolescents (age ranging from 14 to 18 years), and to investigate whether alexithymia was a good discriminatory factor for juvenile delinquency. Thirty-six offender adolescents and 46 non-offender control adolescents participated in the study and completed the 20-item Toronto Alexithymia Scale (TAS-20) (alexithymia), the Revised Children's Manifest Anxiety Scale (R-CMAS) (anxiety), the Liste d'Adjectifs Bipolaires et en Echelles de Likert (LABEL) (personality-Big Five) and demographic data. Findings revealed that the adolescents of the offender group scored high on alexithymia and that proportion of disrupted family structure in the offender group is higher than in the control group. Logistic regressions confirmed that alexithymia and family structure are the strongest discriminatory factors for juvenile delinquency. Limitations and clinical implications are discussed, and recommendations for future research are provided

Parental education and family characteristics: educational opportunities across cohorts in Italy and Spain

Drawing on data contained in the 2005 EU-SILC, this paper investigates the disparities in educational opportunities in Italy and Spain. Its main objective is to analyse the predicted probabilities of successfully completing upper-secondary and tertiary education for individuals with different parental backgrounds, and the changes in these probabilities across birth cohorts extending from 1940 to 1980. The results suggest that the disparities in tertiary education opportunities in Italy tend to increase over time. By contrast, the gap in educational opportunity in Spain shows a marked decrease across the cohorts. Moreover, by using an intuitive decomposition strategy, the paper shows that a large part of the educational gap between individuals of different backgrounds is “composed” of the difference in the endowment of family characteristics. Specifically, it seems that more highly educated parents are more able to endow their children with a better composition of family characteristics, which accounts for a significant proportion of the disparities in educational opportunity.

Re-description of Trypanosoma corvi Stephens and Christophers,1908 Emend. Baker, 1976 and remarks on the Trypanosomes of the Avian Family Corvidae

The trypomastigote, epimastigote and amastigote stages of Trypanosoma corvi Stephens and Christophers, 1908 emend. Baker, 1976 from the peripheral blood, heart and bone marrow are described herein. Other trypanosomes described from the Corvidae are compared to T. corvi and their status is discussed.