Medical and legal professionals' attitudes towards confidentiality and disclosure of clinical information in forensic settings: a survey using case vignettes.

OBJECTIVE: When potentially dangerous patients reveal criminal fantasies to their therapists, the latter must decide whether this information has to be transmitted to a third person in order to protect potential victims. We were interested in how medical and legal professionals handle such situations in the context of prison medicine and forensic evaluations. We aimed to explore the motives behind their actions and to compare these professional groups. METHOD: A mail survey was conducted among medical and legal professionals using five fictitious case vignettes. For each vignette, participants were asked to answer questions exploring what the professional should do in the situation and to explain their justification for the chosen response. RESULTS: A total of 147 questionnaires were analysed. Agreement between participants varied from one scenario to another. Overall, legal professionals tended to disclose information to a third party more easily than medical professionals, the latter tending to privilege confidentiality and patient autonomy over security. Perception of potential danger in a given situation was not consistently associated with actions. CONCLUSION: Professionals' opinions and attitudes regarding the confidentiality of potentially dangerous patients differ widely and appear to be subjectively determined. Shared discussions about clinical situations could enhance knowledge and competencies and reduce differences between professional groups.

L'Adquisició de les propietats morfosintàctiques i discursives dels pronoms clítics catalans en un context escolar

Els pronoms clítics representen una de les idiosincràsies més singulars de la llengua catalana, tant pel seu polimorfisme com per les funcions sintàctiques i discursives que poden exercir en una oració. L’interès principal del nostre estudi és que, tot i les semblances dels sistemes pronominals inherents a les llengües romàniques, unes diferències fonamentals les separen tenint en compte els pronoms clítics: és el cas del català i del portuguès. Per aquest motiu, ens hem proposat d’observar l’adquisició dels pronoms clítics catalans per part d’alumnes que tenen com a primera llengua el portuguès i el català com a segona. Els pronoms objecte d’estudi han estat, d’una banda, els d’acusatiu i de datiu: tot i que són semblants en català i en portuguès pel que fa a la forma, ocupen posicions respecte del verb oposades. D’altra banda, els pronoms catalans en i hi no tenen equivalents en portuguès i, per tant, és rellevant observar-ne l’ús en lusoparlants, sobretot en contextos en què apareixen com a pronom de represa d’un element dislocat.

Tissue biomarker development in a multicentre trial context: a feasibility study on the PETACC3 stage II and III colon cancer adjuvant treatment trial.

PURPOSE: We evaluated the feasibility of biomarker development in the context of multicenter clinical trials. EXPERIMENTAL DESIGN: Formalin-fixed, paraffin-embedded (FFPE) tissue samples were collected from a prospective adjuvant colon cancer trial (PETACC3). DNA was isolated from tumor as well as normal tissue and used for analysis of microsatellite instability, KRAS and BRAF genotyping, UGT1A1 genotyping, and loss of heterozygosity of 18 q loci. Immunohistochemistry was used to test expression of TERT, SMAD4, p53, and TYMS. Messenger RNA was retrieved and tested for use in expression profiling experiments. RESULTS: Of the 3,278 patients entered in the study, FFPE blocks were obtained from 1,564 patients coming from 368 different centers in 31 countries. In over 95% of the samples, genomic DNA tests yielded a reliable result. Of the immmunohistochemical tests, p53 and SMAD4 staining did best with reliable results in over 85% of the cases. TERT was the most problematic test with 46% of failures, mostly due to insufficient tissue processing quality. Good quality mRNA was obtained, usable in expression profiling experiments. CONCLUSIONS: Prospective clinical trials can be used as framework for biomarker development using routinely processed FFPE tissues. Our results support the notion that as a rule, translational studies based on FFPE should be included in prospective clinical trials.

Movement, impacts and management of plant distributions in response to climate change: insights from invasions

A major challenge in this era of rapid climate change is to predict changes in species distributions and their impacts on ecosystems, and, if necessary, to recommend management strategies for maintenance of biodiversity or ecosystem services. Biological invasions, studied in most biomes of the world, can provide useful analogs for some of the ecological consequences of species distribution shifts in response to climate change. Invasions illustrate the adaptive and interactive responses that can occur when species are confronted with new environmental conditions. Invasion ecology complements climate change research and provides insights into the following questions: i) how will species distributions respond to climate change? ii) how will species movement affect recipient ecosystems? and iii) should we, and if so how can we, manage species and ecosystems in the face of climate change? Invasion ecology demonstrates that a trait-based approach can help to predict spread speeds and impacts on ecosystems, and has the potential to predict climate change impacts on species ranges and recipient ecosystems. However, there is a need to analyse traits in the context of life-history and demography, the stage in the colonisation process (e.g., spread, establishment or impact), the distribution of suitable habitats in the landscape, and the novel abiotic and biotic conditions under which those traits are expressed. As is the case with climate change, invasion ecology is embedded within complex societal goals. Both disciplines converge on similar questions of "when to intervene?" and "what to do?" which call for a better understanding of the ecological processes and social values associated with changing ecosystems.

La Traducció al català en el context de la Unió Europea

"Traducció jurídicoeconòmica d'una fragment del Tractat pel qual s'estableix una Constitució per a Europa, amb el propòsit d'establir una sèrie de directrius sòlides per a la traducció al català en el context de la Unió Europea, tot seguint les indicacions dels organismes catalans competents."

La CPP en el context sanitari

Finançament del Nou Hospital Universitari de Son Dureta: Col·laboració público-privadaes un treball de recerca que tracta sobre la financiació d’un hospital respecte a la sevaconstrucció i la posterior explotació.En aquest treball podem trobar dos parts ben diferenciades: la part teòrica i la part practica.En la primera part del treball analitzem com és un contracte de col·laboració públicoprivada(CPP), per després identificar els principals axiomes d’aquests tipus de contractesen el contracte de CPP que s’ha realitzat per la financiació del Nou Hospital de Son Dureta.En la segona part, analitzem la col·laboració publico- privada que s’ha realitzat en aquesthospital concret. S’ha analitzat des de un punt de vista econòmic, polític i social.També s’ha fet una comparació de la col·laboració público-privada envers la col·laboraciótradicional. Les conclusions de la comparació son des de el punt de vista de l’administració,el sector privat i dels usuaris.És realment més eficient, econòmicament parlant, la col·laboració público-privada que lacol·laboració tradicional?La CPP és un recurs que utilitza l’estat per tal de disminuir el deute i sanejar els seuscomptes?Realment es guanya amb qualitat per l’entrada del sector privat en temes d’administraciópública?Qui és el principal beneficiat per la realització d’aquest tipus de col·laboració (sectorpúblic, sector privat, usuaris)?Aquestes són algunes de les hipòtesi que hem intentat anar responent al llarg del treball.

Spatially-resolved eigenmode decomposition of red blood cells membrane fluctuations questions the role of ATP in flickering.

Red blood cells (RBCs) present unique reversible shape deformability, essential for both function and survival, resulting notably in cell membrane fluctuations (CMF). These CMF have been subject of many studies in order to obtain a better understanding of these remarkable biomechanical membrane properties altered in some pathological states including blood diseases. In particular the discussion over the thermal or metabolic origin of the CMF has led in the past to a large number of investigations and modeling. However, the origin of the CMF is still debated. In this article, we present an analysis of the CMF of RBCs by combining digital holographic microscopy (DHM) with an orthogonal subspace decomposition of the imaging data. These subspace components can be reliably identified and quantified as the eigenmode basis of CMF that minimizes the deformation energy of the RBC structure. By fitting the observed fluctuation modes with a theoretical dynamic model, we find that the CMF are mainly governed by the bending elasticity of the membrane and that shear and tension elasticities have only a marginal influence on the membrane fluctations of the discocyte RBC. Further, our experiments show that the role of ATP as a driving force of CMF is questionable. ATP, however, seems to be required to maintain the unique biomechanical properties of the RBC membrane that lead to thermally excited CMF.

Pharmaceutical and Industrial Traits in Genetically Modified Crops: Co-existence with Conventional Agriculture, August 2006

This paper discusses the implications of using genetically modified crops to biomanufacture pharmaceuticals and industrial compounds from the perspective of their co-existence with conventional agriculture. Such plant-made pharmaceuticals and plantmade industrial products rely on exciting scientific and technological breakthroughs and promise new opportunities for the agricultural sector, but they also entail novel risks. The management of the externalities and of the possible unintended economic effects that arise in this context is critical and poses difficult questions for regulators.

Organization of healthcare and assistance to the elderly indigenous population: synergies and particularities of the professional context

This study aimed to describe the effects of the organization of primary healthcare on the assistance provided to the elderly Kaingang population, according to the perception of health professionals that work in this area. It is a qualitative and descriptive study, supported by ethnography methodological references, and was conducted with ten healthcare professionals that work in Faxinal, an indigenous territory in the state of Paraná, in Brazil. Data was collected from November 2010 to February 2012 through participant observation and interviews. The results revealed that health professionals strive to meet the health needs of the elderly Kaingang people; however, there are negative effects that hinder the professional care, especially limited human resources, lack of training and material resources, heavy workload and high turnover rates. This study highlights the need to improve work conditions in order to provide better healthcare.