Healthcare Power of Attorney

A health care power of attorney (HC-POA) is a document authorizing an attorney-in-fact (your designated agent) to make health care decisions on your behalf if you (the principal) are unable, in the judgment of your attending physician, to make health care decisions. Health care is defined as any care, treatment, service or procedure required to maintain, diagnose or treat a physical or mental condition. Through your HC-POA, you may authorize someone else to consent, refuse or withdraw consent to health care on your behalf. The attorney-in-fact is permitted to make only health care-related decisions on your behalf. In exercising this authority, the attorney-in-fact must act consistently with your desires (as stated in the HC-POA document).

Considering a Living Will

A living will is a written declaration informing medical personnel whether certain life-sustaining procedures should be withheld or withdrawn if (1) you are in a terminal condition; and (2) you are unable to decide for yourself. You (the declarant) may execute a living will declaration as a stand-alone document or you may include a living will within a health care power of attorney document. A living will can be revoked at any time and in any way by communicating the revocation to anyone who was aware that the living will existed.

Involuntary Discharge from a Long-Term Facility

An involuntary discharge from a long-term care (LTC) facility occurs when the facility provides a 30-day written notice to a resident informing him/her of the need to move out of the facility. The notice must set out the reasons for the transfer or discharge as well as state the effective date, location of transfer or discharge, statement of appeal rights and the contact information (name, address and telephone number) for the Office of the State Long-Term Care Ombudsman.

Porta-enxertos promissores, alternativos ao limoeiro 'Cravo', nos Tabuleiros Costeiros de Sergipe

Resumo: O objetivo deste trabalho foi identificar porta-enxertos alternativos ao limoeiro 'Cravo' comum, para produção de laranja 'Pêra', nas condições dos Tabuleiros Costeiros de Sergipe. Foram avaliados 43 porta-enxertos quanto a altura, copa, taxa fotossintética, teor de prolina, eficiência produtiva, produção e produtividade por planta. O limoeiro 'Cravo' comum foi considerado como padrão. Os porta-enxertos híbrido TSKC x (LCR x TR) - 059, citrandarim 'Riverside', limoeiro 'Cravo CNPMF - 03' e outros 12 superaram o limoeiro 'Cravo' comum na indução de eficiência produtiva à copa; limoeiro 'Rugoso Vermelho', citrandarim 'Indio' e mais quatro promoveram maior produtividade; TSKC x CTRK - 001 e TSKFL x CTC13 - 012 se destacaram pela magnitude da assimilação de CO2; e TSKC x (LCR x TR) - 040 e TSKC x CTRK - 001 apresentaram maior acúmulo de prolina. São considerados alternativas promissoras os seguintes porta-enxertos: híbrido TSKC x (LCR x TR) - 059; citrandarins 'Indio', 'Riverside' e 'San Diego'; limoeiros 'Rugoso Vermelho' e 'Cravo CNPMF - 03'; e híbridos TSKC x CTRK - 001, TSKFL x CTC13 - 012, TSKC x (LCR x TR) - 040, TSKC x LHA - 006, TSKC x CTQT1434 - 001, TSKC x CTSW - 058 e TSKFL x CTARG - 028.

CARACTERIZAÇÃO DE FRUTOS E PROPAGAÇÃO DE PORTA-ENXERTOS HÍBRIDOS DE CITROS EM AMBIENTE PROTEGIDO

A diversificação de uso de porta-enxertos de citros é importante no Brasil devido à presença de diversos estresses abióticos e bióticos, além da busca por atributos horticulturais desejáveis como nanismo, alta eficiência de produção e indução de boa qualidade aos frutos. Para a seleção de um genótipo com potencial de uso como porta-enxerto, porém, o desempenho na fase de propagação também é relevante. Assim, caracterizaram-se os frutos e avaliou-se a propagação em ambiente protegido de porta-enxertos híbridos de citros obtidos ou selecionados pelo Programa de Melhoramento Genético de Citros da Embrapa: citrandarins ‘Indio’, ‘Riverside’ e ‘San Diego’, híbridos HTR-051, TSKC x (LCR x TR)-040 e 059, LVK x LCR-010 e 038, TSKC x CTTR-002, TSKC x CTSW-041 e LCR x TR-001, além das variedades comerciais citrumelo ‘Swingle 4475’, trifoliata ‘Flying Dragon’, limoeiro ‘Cravo Santa Cruz’ e tangerineira ‘Sunki Tropical’. Foram avaliados variáveis biométricas, fisiológicas e coeficientes técnicos. O delineamento experimental foi em blocos ao acaso, com quatro repetições e 50 plantas na parcela ou 20 frutos por genótipo, conforme a avaliação. Citrumelo ‘Swingle’ e LVK x LCR-010 apresentaram alta produção de sementes por fruto, enquanto HTR-051 e LCR x TR-001 produziram as menores quantidades. A poliembrionia foi superior para TSKC x CTTR-002, TSKC x (LCR x TR)–040, LCR x TR-001, citrandarins ‘Indio’, ‘Riverside’ e ‘San Diego’ e tangerineira ‘Sunki Tropical’, tendo trifoliata ‘Flying Dragon’ e LVK x LCR-010 apenas 45% de poliembrionia média. A emergência de citrandarin ‘Riverside’ foi mais rápida e uniforme em relação aos demais genótipos. O crescimento vegetativo da parte aérea e do sistema radicular foi superior para citrandarin ‘Riverside’, TSKC x (LCR x TR)-059, tangerineira ‘Sunki Tropical’, citrumelo ‘Swingle’ e limoeiro ‘Cravo’ e seus híbridos. Todos os híbridos de citros avaliados apresentam potencial de uso como porta-enxertos.

PRODUÇÃO DE MUDAS DE CITROS COM DIFERENTES COMBINAÇÕES COPA E PORTA-ENXERTO EM VIVEIRO PROTEGIDO

RESUMO O objetivo deste trabalho foi avaliar a produção de mudas de laranjeiras doces ‘Pera’ e ‘Westin’, tangerineira-tangor ‘Piemonte’ e limeira-ácida ‘Tahiti’ enxertadas em 14 porta-enxertos de citros em viveiro protegido. As mudas de laranjeiras-doces ‘Pera D-6’ e ‘Westin’, tangerineira-tangor ‘Piemonte’ e limeira-ácida ‘Tahiti CNPMF-02’ foram avaliadas em viveiro protegido após a enxertia, em 11 porta-enxertos híbridos: citrandarins ‘Indio’, ‘Riverside’ e ‘San Diego’, citrumelo ‘Swingle 4475’, HTR-051, TSKC x (LCR x TR)-040 e 059, LVK x LCR-010 e 038, TSKC x CTTR-002 e TSKC x CTSW-041, além de trifoliata ‘Flying Dragon’, limoeiro ‘Cravo Santa Cruz’ e tangerineira ‘Sunki Tropical’. Coletaram-se variáveis biométricas e fisiológicas, sendo o delineamento experimental em blocos ao acaso, em parcelas subdivididas, com 56 tratamentos, três repetições e dez plantas na parcela. Independentemente do porta-enxerto, a limeira-ácida ‘Tahiti CNPMF-02’ foi a copa mais vigorosa em viveiro, seguida da tangerineira-tangor ‘Piemonte’ e, por fim, pelas laranjeiras ‘Pera-D6’ e ‘Westin’. A tangerineira ‘Sunki Tropical’ induziu maior crescimento vegetativo e de sistema radicular em combinação com todas as copas estudadas. O trifoliata ‘Flying Dragon’ e o híbrido HTR-051 necessitam de maior período para a formação das mudas em função do menor vigor desses genótipos, em combinação com todas as variedades copas avaliadas. Não se observaram quaisquer sintomas de incompatibilidade entre as variedades no viveiro.

Does soil moisture overrule temperature dependence of soil respiration in Mediterranean riparian forests?

Soil respiration (SR) is a major component of ecosystems' carbon cycles and represents the second largest CO2 flux in the terrestrial biosphere. Soil temperature is considered to be the primary abiotic control on SR, whereas soil moisture is the secondary control factor. However, soil moisture can become the dominant control on SR in very wet or dry conditions. Determining the trigger that makes soil moisture as the primary control factor of SR will provide a deeper understanding on how SR changes under the projected future increase in droughts. Specific objectives of this study were (1) to investigate the seasonal variations and the relationship between SR and both soil temperature and moisture in a Mediterranean riparian forest along a groundwater level gradient; (2) to determine soil moisture thresholds at which SR is controlled by soil moisture rather than by temperature; (3) to compare SR responses under different tree species present in a Mediterranean riparian forest (Alnus glutinosa, Populus nigra and Fraxinus excelsior). Results showed that the heterotrophic soil respiration rate, groundwater level and 30 cm integral soil moisture (SM30) decreased significantly from the riverside moving uphill and showed a pronounced seasonality. SR rates showed significant differences between tree species, with higher SR for P. nigra and lower SR for A. glutinosa. The lower threshold of soil moisture was 20 and 17% for heterotrophic and total SR, respectively. Daily mean SR rate was positively correlated with soil temperature when soil moisture exceeded the threshold, with Q10 values ranging from 1.19 to 2.14; nevertheless, SR became decoupled from soil temperature when soil moisture dropped below these thresholds.

Conversioni al cattolicesimo a Roma tra Sei e Settecento. La presenza degli scandinavi nell’Ospizio dei Convertendi.

In my PhD dissertation, I have examined a group of people of Scandinavian origin received by Ospizio dei Convertendi. This group has been hitherto largely unknown to historical research. The Ospizio was an institute founded by the Oratorian Congregation in Rome in 1673 to provide religious instruction and material aid to both recent and aspirant converts to Roman Catholicism. My research traces the profile of converts and a typology of motives, examining different factors which influenced the conversion process. I show that the key factors were often of a social rather than a religious nature. Moreover, I have analyzed the hospice in the context of Counter-Reformation charity as well. In terms of numbers, the Scandinavians formed a somewhat marginal yet not insignificant group within the Roman hospice. Out of a total of 2203 guests received between 1673 and 1706, 4.6 % were Scandinavians: 74 Swedes (including Finland and Livonia) and 27 Danes (including Norway). They came from a rigorously Protestant region which reacted to Catholicism with severe legislative measures. Converts to Catholicism risked confiscation of their goods, expulsion or even capital punishment. Since both Sweden and Denmark were practically impenetrable to Catholicism at the time and clandestine missionary attempts often failed before they had even properly started, the Roman Catholic Church shifted its interest towards Northerners arriving in Rome, a preferred destination for young noblemen, artists and migrant craftsmen. The material related to Ospizio dei Convertendi, conserved in the Vatican archives, is a scarcely known yet unusually rich source, not only for the religious history of our continent, but also for social history and the study of migration in early modern Europe. It contains a wealth of information about members of the subordinate classes, of their travels and lives in Europe. The profile delineated in these documents is of individuals who had a wide range of different professions and different aspirations. These documents encompass a vast social spectrum that was highly mobile on a continent which by that time had become pluriconfessional. Therefore, these migrants faced the complex religious reality in their everyday life. The principal corpus of my research consists of two types of manuscript sources created for administrative and in a way also for apologetic purposes of the Roman Catholic Church. My starting point is the Primo registro generale of Ospizio dei Convertendi. This is a volume in which the following information about each guest was registered: name, nationality, city of origin, age, sex, profession, confession professed before converting, date of arrival, departure, abjuration and baptism. Typically, the convert was male, originating from Stockholm or Copenhagen, from 21 to 30 years of age. The biggest occupational groups in descending order were soldiers, noblemen, craftsmen and sailors. Thus the data reflects a multiform reality of interurban and long distance migration, ideals regarding the education of young noblemen and gentry as well as the need of European armies to hire foreign mercenaries in their various campaigns. Against this background the almost total absence of women is hardly surprising: there is only one woman in the material I have studied. The second main source, Nota degl’ospiti ricevuti e spese fatte per essi, sheds more light on the choices of the converts, their motivations and their lives outside Scandinavia before reaching Rome. This narrative material permits an analysis which completes but also goes far beyond the columns of the Institute’s general register. This material consists of reports written by Catholic priests based on an interview conducted upon each guest’s arrival. The material frequently includes information on what the converts would do following their departure from the Institute as well. These sources have a specific narrative form and contain short biographies, list reasons for converting and information about the journey from the North to the Mediterranean - a journey which in many cases took several years. Moreover, they show that certain unorthodox practices such as calling on the saints and pleading for help from them were not uncommon in the Protestant popular religion. The recording of information on conversions from Protestantism to Catholicism reflects both religious and social interest on the part of the receiving institute. The information obtained was used for the purposes of religious teaching, for finding adequate ways of inserting the convert into Italian society so that he could earn a living, and to find effective methods to convert others with a similar cultural and geographical background. The stories recorded were based on interviews with the newly-arrived, information obtained from a travel companion or fellow countrymen, or from written documents the aspirant converts carried with them. These sources illustrate, although sometimes in rather simplified ways, the circumstances and motivations which were relevant to the choice of changing one’s confession. In addition, I have examined petitions addressed to the hospice and other Roman authorities in order to get financial aid. These petitions were written by Italian scrittori, and they contain certain conventions and topoi of presenting the conversion with the purpose of improving the chances of obtaining financial aid. It is through these filters, which may seem initially almost invisible, that the remote voice of the converts reaches us. The results of the analysis are particularly interesting because they disagree with some of the principal conclusions of previous work on the subject. First, earlier research has focused almost exclusively on the conversions of noblemen, and has argued, second, that the Queen Christina of Sweden was the driving force behind their change of confession. The sources examined for this dissertation present a profile of long-distance migrants, many of them members of the subordinate classes, who were looking for ways to make their living in Europe. These people had in many cases left their country of origin several years earlier and not for religious reasons, so, crucially, we are not dealing with confessional migration in these cases. Rather, conversion was a complex process, intricately tied up with strategies of survival, integration and upward social mobility. At the same time, while these components are significant on their own right, they do not necessarily point to the absence of motivations of a more clearly religious nature.

Den vårdande och helande bilden: möten med bildkonst i vårdandets värld

Denna vårdvetenskapliga avhandling syftar till att avtäcka och belysa en vårdande och helande dimension vid existentiellt lidande patienters möten med bildkonst inom vårdkontext. Kunskapssökandet sker i två studier. Den första (studie I) är en ikonografi sk tolkning av konstnären Matthias Grünewalds (ca 1460–1528) senmedeltida altarskåpsmålningar. I studien uttolkas lidandets uttryck och narrativa budskap samt symboliska gestaltningar av vårdande och helande i valda delar av detta s.k. Isenheimaltares bildprogram. Tolkningen utgår från rekonstruktionen av altarskåpets ursprungskontext, det medeltida Isenheimklostret, där svårt sjuka och döende patienter vårdades. I studie två (II) fortsätter sökandet i den moderna hospicevårdens kontext med hjälp av en kvalitativ intervjustudie som utforskar patienters meningsskapande vid möten med självvald bildkonst (oljemålningar och akvareller av fi nländska konstnärer som donerats till det sjukhus där intervjustudien gjordes). Forskningsansatsen är inspirerad av Hans-Georg Gadamers (1901–2002) hermeneutik. Vidare används några nyare tolkningsteoretiska ansatser inom bildkonstens område. Forskningens tolkningsresultat visar att bildkonsten har potentialer såväl på ett miljöestetiskt plan som på en djupare individuell symbolnivå. Som designkomponent i vårdmiljöns rumsliga gestaltning bygger bildkonsten in estetiska, etiska och andliga kvaliteter utifrån tidsmässiga och kulturella koder. I den medeltida klostervårdens kontext sammanföll bildkonstens dekorativa betydelse med andliga och helande syften. När det gäller självvalda konstverk i den moderna vårdkontexten bidrar de till det enskilda patientrummets atmosfär på ett unikt sätt utifrån patientens personlighet och behov. På en fördjupad mötesnivå, i samspel med bildens symboliska funktion, sker en inlevelsemässig förfl yttning in i bildens värld. Betraktarens inlevelse aktiveras till en transcenderande rörelse som går bortom det faktiska rummets och den reella tidens gränser. Vid resor i konstens bildvärld spelas minnesvärda händelser upp från det förgångna, men även framtiden kommer betraktaren till mötes. I en existentiell livssituation söker människan i konstverkets bildinnehåll efter symbolisk mening som kan ge svar på lidandets frågor. Bilderna iscensätter då helande motbilder som utgör korrektiv i symboliska former när olika existentiella förluster hotar. När livet förbleknats av sjukdom besvarar bildvärlden den lidandes blick med lysande violer som blommar upp, ger livskraft och bekräftar personens värdighet mitt i det förvissnande människolivet. När ångest och otrygghet nalkas inbjuds betraktaren till besök i landskap som utvidgar sjukhusrummets väggar mot hemgårdens trygghet. Där livet hotas av förgänglighet tar bildvärlden människan med sig till naturens eviga återfödelse. Upplevelsen av att vara delaktig i ett större och heligt sammanhang öppnar vägen ut ur lidandets avskurenhet. I medeltidens vårdkontext erbjöd den sakrala bilden en kollektiv och helande Symbolon som genom sin representationskraft synliggjorde det osynliga. Vid bildmöten i den moderna hospicevårdens kontext var det naturteman som gläntade på dörren till ”det hemliga rummet i djupet av hjärtat”. Forskningen antyder att även om meningsskapandet i ett bildmöte är avhängigt tidsepok, betraktarens förförståelse och kulturella kontext samt typen av bilder kan bildsymboliken, generellt förstådd som den saknade formen eller det saknade livssammanhanget, framvisa en helande och hoppingivande ordning i lidandets kaos.

METHODOLOGY FOR AUTOMATICALLY DELIMITING PERMANENT PRESERVATION AREAS ALONG WATER COURSES - THE USE OF GIS IN THE HYDROLOGICAL BASIN OF THE SERGIPE RIVER, BRAZIL

ABSTRACT Permanent Preservation Areas (PPAs) along watercourses have been the focus of numerous studies, not only because of the fragility and ecological relevance of riverine vegetation, but also because of the inefficiency demonstrated in conforming to the legislation protecting it. One of the major difficulties encountered in terms of guaranteeing the effective conservation of these riverside areas is the absence of methodologies that can be used to define them rapidly and accurately without manually determining the widths of the rivers or assigning only uniform linear values for the entire watercourse. The present work sought to develop a spatial analysis methodology capable of automatically defining permanent preservation areas along watercourses using geographic information system (GIS) software. The present study was undertaken in the Sergipe River basin, "considering the river itself and its principal affluents. We used the database of the Digital Atlas of Hydrological Resources (SEMARH/SE), and the delimitations of the PPAs were performed using ArcGIS 10.1 and the XToolPro 9.0 extension. A total of 5,003.82 hectares of Permanent Preservation Areas were delimited along the margins of the rivers analyzed, with a margin of error of <1% in delimiting the widths of the rivers within the entire area considered. The methodology described here can be used to define PPAs efficiently, relatively rapidly, and with very small margins of error, thus representing a technological advance in terms of using GIS for land management.

Pohjoiset maisemat : "Eurooppalaisen maisemayleissopimuksen toteuttaminen Pohjois-Kalotin kunnissa" - Konferenssi Inarissa 7.-9.9.2011

Kansainvälinen Eurooppalaisen maisemayleissopimuksen tavoitteiden saavuttamista edistävä konferenssi järjestettiin Inarissa 7.-9.9.2011. Konferenssissa käsiteltiin maisemasopimuksen tavoitteita, tarpeita ja mahdollisuuksia Pohjois-Kalotin alueella. Tähän raporttiin on koottu konferenssissa esiintyneiden asiantuntijoiden laatimat artikkelit aiheesta. Raportin toivotaan helpottavan alueiden käytön suunnittelijoita käytännön työssään ja rohkaisevan kuntia toteuttamaan tulevaisuuden suunnittelua Eurooppalaisen maisemayleissopimuksen tavoitteiden mukaisesti. Raportti on saatavissa viidellä eri kielellä: suomeksi, ruotsiksi, norjaksi, pohjoissaameksi ja englanniksi. Pohjois-Kalotin aluetta yhdistää yhteinen tunnusomainen maisema. Saamelaiskulttuurin sekä poronhoidon muovaamat tunturimaisemat ja upeat jokivarsimaisemat heijastuvat ympäristössä laaja-alaisesti. Alueen maisemalle haasteita tuovat sen moninaiset maankäyttömuodot ja elinkeinot, kuten matkailu, kaivosteollisuus ja energiantuotanto. Arvokkaiden maisemapiirteiden säilyttäminen vaatii erityistä tuntemusta ja tietämystä alueen kunnissa. Maisemansuojelua ja -hoitoa toteutetaan alueiden- ja maankäytön suunnittelun kautta, pääasiallisesti kaavoituksella ja maisemanhoitosuunnitelmilla. Pohjois-Kalotin alueen kunnissa on erilaiset osin toisistaan poikkeavat toimintatavat ja käytännöt maisemanhoidossa. Kuitenkin alueen asukkailla on yhtäläisiä intressejä elinympäristönsä suojeluun ja säilyttämiseen. Maisema nähdään vetovoimatekijänä, jota ei haluta menettää. Lisääntyvät maankäyttötarpeet kunnissa luovat tarpeen entistä moniulotteisemmalle suunnittelulle. Paikallisten tahojen osallistaminen suunnitteluprosesseihin aikaisessa vaiheessa ja monimuotoinen vuorovaikutus, niin toimijoiden, kansalaisten kuin viranomaisten välillä vähentää konfliktien muodostumista. Tutkimustiedon tehokkaampi hyödyntäminen ja valtiorajat ylittävä yhteistyö helpottaa päätöksentekoa ja luo yhteisiä linjoja maisemansuojelutyöhön. Yhteiset kokemukset, käytännöt ja tietotaidon jakaminen sekä laajemman maisemakokonaisuuden hahmottaminen parantaa eurooppalaisen maisemayleissopimuksen tavoitteiden toteutumista. Työn jatkuvuuden varmistamiseksi Pohjois-Kalotin alueelle suunnitellaan perustettavaksi maisemayhteistyöryhmä, jonka tehtävä on maisemapolitiikan kehittäminen ja eteenpäin vieminen.

Northern Landscapes : ʻʻImplementation of the European Landscape Convention In the North Calotte Area Municipalitiesʼʼ - Conference in Inari, Finland 7-9.9.2011

The conference promoting the objectives of the international European Landscape Convention (ELC) was held on 7-9 September 2011 in Inari. The primary aim of the conference was to increase awareness of the ELC and the prospects and requirements it brings to practical planning work, especially at the municipal level. The conference speakers included top experts from Sweden, Norway, Finland, France, Holland and Catalonia. This report is a collection of articles written by the experts in the ELC conference. The report is available in five languages: Finnish, Swedish, Norwegian, Northern Sámi and English. The common characteristics of the North Calotte area, such as the magnificent riverside scenery and the beautiful fell landscapes formed by the Sámi culture and reindeer management are broadly reflected in the environment. Alongside the traditional forms of land use, many other livelihoods and forms of land use now need to be accommodated in the area. Tourism, energy production, mining industry and new infrastructure create new and manifold challenges to the authorities in charge of land use in these areas. Municipalities need information and support for versatile planning in the future, so that the unique and valuable characteristics of the North can be preserved. Landscape protection and management in the landscape areas is executed through areal and land use planning, mainly through town planning and the creation of landscape management plans. The municipalities in the North Calotte region have their own partly divergent methods and practices, based on the various land use processes are executed. The municipalities and inhabitants have a great interest in preserving and protecting their living environment and maintaining and increasing the appeal of the area. Landscape is viewed as one of the most significant appealing factors that cannot be lost. The increasing land use in municipalities, for example due to energy production, mining industry and increasing tourism, create a need for more multidimensional planning. The reconciliation of the wishes of different interest groups, and traditional and new livelihoods will not be easy. Conflict is inevitable. This will lead to a greater need to engage local bodies to the planning processes right from the start of the projects. Close cooperation between different administrative branches, operators, local bodies and landscape research promote the objectives of the convention. To ensure that the work continues, a landscape co-operation group is planned to be established in the North Calotte area. It´s main task is to promote and develop landscape policy in the area.