Apresentam-se os resultados clínicos principais de uma primeira investigação efectuada a familiares de doentes sob tratamento paliativo no domicílio da área de Lisboa, com o instrumento de medida da satisfação SERVQUAL Modificado. Dos 58 familiares/doentes que responderam ao questionário apenas uma minona estava insatisfeita (uma classe de 5 indivíduos mostra-se francamente insatisfeita), uma classe de 15 estava moderadamente satisfeita, havendo 38 individuos fortemente satisfeitos com a qualidade e prontidäo dos serviços prestados. Porém urna percentagem elevada de doentes, segundo a opinião (...) retrospectiva dos cuidadores, faleceu com sintomatologia agravada, nomeadamente dores (60%), obstipação (67%) e depressão/ansiedade (43%). Discute-se a consistência e validade do questionáno SERVQUAL Modificado, contextualizam-se os resultados no que é o standard da prática da MCP e integram-se na promoção da dignidade humana no fim da vida. We present the main clinical findings of research on palliative home care, carried out among relatives of patients in the Lisbon area. An adapted version of SERVQUAL was used. Of a total of 58 carers surveyed only a small number (5) was unsatisfied 15 were only moderately satisfied. 38 family carers were strongly satisfied with the services. Yet, a high percentage of patients, as viewed in retrospect by their relatives died with some aggravated symptoms: 60% with more pain, 67% constipation, and 43% anxiety/depression. We discuss the consistency and validity of this adapted SERVQUAL tool and the main results are contextualized beanng in mind the standard practice of palliative medicine and the pursuit of human dignity in death. (shrink)

The diversity in colour patterns on butterfly wings provides great potential for understanding how developmental mechanisms may be modulated in the evolution of adaptive traits. In particular, we discuss concentric eyespot patterns, which have been shown by surgical experiments to be formed in response to signals from a central focus. Seasonal polyphenism shows how alternate phenotypes can develop through environmental sensitivity mediated by ecdysteroid hormones, whereas artificial selection and single gene mutants demonstrate genetic variation influencing the number, shape, size, position, (...) and colour composition of the eyespots. The expression patterns of the regulatory gene Distal-less reveal that these changes can arise at several different developmental stages, and the phenotypes indicate that some forms of changed pattern may occur much more readily than others. Further study of the genes, of the developmental mechanisms, and of the functions of the patterns will provide novel insights about the evolution of morphological diversity. BioEssays 21:391–401, 1999. © 1999 John Wiley & Sons, Inc. (shrink)

A marked feature of eukaryotic programmed cell death is an early drop in mitochondrial transmembrane potential. This results from the opening of permeability transition pores, which are composed of adenine nucleotide translocators and mitochondrial porins. The latter share striking similarites with bacterial porins, (including down‐regulation of their pore size by purine nucleotides), suggesting a common origin. The porins of some invasive bacteria play a crucial role during their accommodation inside the host cell and this co‐existence resembles the endosymbiotic origin of (...) mitochondria. The above observations suggest that early in eukaryotic evolution, former invaders may have used porin‐type channels to enter their host and to induce its death when the levels of its cytoplasmic purine nucleotides were dropped. The appearance of adenosine nucleotide translocators in the primitive eukaryotes, which permitted usage of the oxidative metabolism of the invaders, provided the basis for the permeability transition phenomena, now linked to the apoptotic process. Bcl‐2‐type molecules, being able to modulate the permeability transition pores by interaction with adenosine nucleotide translocators, may have played an essential role in conferring a means of controlling apoptosis. (shrink)

Due to impaired communication, people with aphasia are often in a vulnerable situation and face barriers in accessing health information. This article discusses the contributions ofaugmentative and alternative communication for people with aphasia in optimizing communication, improving language recovery, and mainly in providing education and increasing access to healthinformation. This can be translated into a positive impact on respect for autonomy right, well-being, quality of life, and health outcomes (further participation in the decision-making process, involvement,independence, and control of the rehabilitation (...) process). Health professionals, including nurses, must have communication skills to communicate effectively with this population and also be prepared to useaugmentative and alternative communication strategies. (shrink)

Neste artigo interessa-nos abordar alguns aspectos sobre a relação entre a Sagrada Escritura e a Liturgia, de modo particular aqueles elementos concernentes à reorganização e confecção levadas a cabo pela reforma litúrgica do concílio Vaticano II do livro litúrgico que contém as perícopes bíblicas lidas na liturgia da Palavra durante as celebrações eucarísticas, isto é, o Lecionário da Missa. Para esta abordagem, nos servirá, em grande medida, o relato sobre os trabalhos da Reforma Litúrgica - relato este ainda inédito no (...) Brasil - escrito por D. Annibale Bugnini, Secretário do Consilium, a comissão encarregada para a aplicação dos princípios de reforma estipulados pela Constituição Sacrosanctum Concilium. (shrink)

Recent trends in academic and professional legal communication worldwide have promoted significant changes to aim at operating successfully under current multilingual and multilegal contexts. The aim is to consider a kind of supranational legal discourse so as to minimize socio-cultural variants and to promote the pragmatic conditions for harmonized and ‘common sense’ legal practices without excluding potential reciprocal influences of or resistance to one hegemonic legal system upon others. In Brazil, the traditional ‘thinking like a civil lawyer’ culture still prevails (...) against a more global approach constraining the consolidation of the country’s role of major player in most global legal areas. In addition, the key tool required for achieving some sort of global legal status—Brazilian legal operators’ proficiency in legal English—has been barely considered in both academic and professional settings, particularly in legal translation. This study resorts to the linguistic anthropology concept of ‘entextualization’ to discuss the process of official translation in Brazil to render global legal genres. The comparative analysis between the original text in English and its official version in English focus on drafting consistency, the translator’s choice of some formal entextualization elements used in the process of translation and his/her authority as the entextualizing agent to legitimate text. (shrink)

Our purpose in this article is to explore the reasons for the continued attractiveness of Simmel's thought today and to probe the contemporary affinities to his philosophical stance towards the world. Simmel anchored the ‘philosophical attitude' in the philosopher’s particularly developed disposition for Erlebnis, i.e. the unified pre-conceptual experience of each moment of reality and life, as well as in a particular mode of objectivating this experience. We provide an illustration of such an approach and its implications through Simmel's analysis (...) of ‘remoteness from oneself’ and the restlessness it entails in The Philosophy of Money. We argue that Simmel's attempt at phenomenologically unveiling the contours and depths of life moments and fragments, as well as his emphasis on constant movement, provide much reassurance to contemporary subjectivities. But his philosophical stance is also driven by a quasi-mystical yearning for the One that lies beneath and beyond the fragments. We propose an initial assessment of the main implications of such a stance by relating it to the philosophical path it opened up (a path directly linking to Heidegger and his followers, but also in part to Deleuze) and by placing it in what we understand to be the new philosophical situation today. (shrink)

O presente artigo visa descrever a expenência e perspectiva de dois psicólogos na aplicação de cerca de 100 questionários SERVQUAL, num contexto de cuidados paliativos ao domicílio. Embora a prioridade na aplicação de um questionário seja a obtenção de dados, esta experiência em particular acabou por revelar todo um conjunto de questões psicológicas e emocionais que dificilmente poderiam ser traduzidas por números. É sobre essas questões que o artigo se debruça, contemplando ainda algumas considerações sobre a forma de aplicar questionários (...) nesta área da medicina, bem como os desafios que ainda estão presentes, nomeadamente no apoio integral a pessoas com doenças terminais e seus familiares. The present article was wrítten with the intention to describe the field expenence of two psychologists throughout the application of 100 SERVQUAL questionnaires to families receiving a home-based palliative care. The primary goal of this study was to obtain statistical data about the quality of the services provided but along the process, many psychological and emotional issues that can not be translated by numbers were brought up. In this article we make reflections about the above issues and the way how to conduct an investigation in such a delicate area and also some of main challenges that we still face in order to improve the assistance given to the patients and their families. (shrink)

In the last thirty years, the problem of presupposition projection has been taken to provide a decisive argument for a dynamic approach to meaning, one in which expressions are not evaluated with respect to the ‘global’ context of utterance, but rather with respect to a ‘local context’ obtained by updating the global one with expressions that occur earlier in the sentence. The computation of local contexts is taken by dynamic analyses to follow from a generalization of the notion of belief (...) update. I argue that the dynamic approach is faced with a dilemma: in its pragmatic incarnation (Stalnaker), it is explanatory but not general; in its semantic incarnation (Karttunen and Heim), it is general but not explanatory. I suggest that the dilemma stems for a faulty understanding of ‘local contexts’, and I offer a new reconstruction of this notion which eschews belief update but offers a general and fully precise solution to the projection problem. (shrink)

This discussion note addresses Caleb Hazelwood’s ‘Practice-Centered Pluralism and a Disjunctive Theory of Art’. Hazelwood advances a disjunctive definition of art on the basis of an analogy with species concept pluralism in the philosophy of biology. We recognize the analogy between species and art, we applaud attention to practice, and we are bullish on pluralism—but it is a mistake to take these as the basis for a disjunctive definition.

Rid and Wendler propose the development of a Patient Preference Predictor (PPP), an actuarial model for predicting incapacitated patient’s life-sustaining treatment preferences across a wide range of end-of-life scenarios. An actuarial approach to end-of-life decision making has enormous potential, but transferring the logic of actuarial prediction to end-of-life decision making raises several conceptual complexities and logistical problems that need further consideration. Actuarial models have proven effective in targeted prediction tasks, but no evidence supports their effectiveness in the kind of broad (...) spectrum prediction task that is the proposed goal of the PPP. We argue that a more focused approach, targeting specific medical conditions and generating treatment predictions based on the preferences of individuals with actual disease experience, is both more firmly grounded in past research and is a more prudent initial strategy for exploring the efficacy of actuarial prediction in end-of-life decision making. (shrink)

‘Menander has set up a confrontation between this law [the law about epikleroi] and love… He wants the audience to regard the law as stupid and wrong… Surely one of Menander's purposes in writing this play was to make the Athenians consider seriously whether the law ought to be changed.’ Thus Professor D. M. MacDowell in the concluding paragraph of his article ‘Love versus the Law: an Essay on Menander's Aspis’. A similar view was already implicit in E. Karabelias' treatment (...) of the play as indicative of the general attitude to this law in Athens in Menander's day: ‘A n'en point douter, l'épiclérat est ressenti, á l'epoque de Ménandre, comme une anomalie intolérable pour les mceurs de la societe athénienne à la fin du ive s.av.n.è L'épiclérat est odieux et ridicule… L'hostilité envers l'épiclérat est done un signe des temps’. And Professor E. G. Turner has written: ‘it is hard to imagine that the institution of the epiclerate emerged in good standing from this derisory treatment’. (shrink)

This article examines some of S. Lem’s statements about his philosophical and worldview positions regarding the mysterious nature of language and the linguistic sign, the connection between language, mind and reality. The main goal of the paper is to understand what texts on the philosophy of language the Polish thinker read and what attitude he has formed towards them. Lem is the follower of an analytical intellectual culture that focuses on the naturalistic worldview and the consequences of the “linguistic turn” (...) in Western philosophy. For Lem, language is not only an interesting philosophical object, but also a complex precise instrument of his own creative thinking. In this regard, the philosophy of language for a writer cannot be based only on logical-linguistic atomistic methodology. Lem seeks in his contemporary interdisciplinary methods ways to combine realistic and anti-realist positions. Many concepts, such as “the effect of semantic transparency”, “polymorphic language model”, “variation model” are quite correlated with modern theories of language and require additional philosophical comments. (shrink)

For live-related kidney donation, the current UK guidance specifies that the donor has a right to know the recipient’s HIV status. This guidance may prevent some potential recipients from asking friends or family to donate, as they do not wish them to know they are HIV positive. Currently, it is felt necessary that the donor should know the HIV status of the recipient in order to give fully informed consent to the operation. However, the specific medical details are not required (...) in order to allow for donor informed consent. This consent requires knowledge of the general expectation for survival of a graft and the specific expectation for survival of this graft in the recipient; it does not require specific knowledge of the recipient’s medical condition. (shrink)

В работе рассматриваются некоторые актуальные аспекты творчества великих философов, писателей и поэтов - тех мыслителей, которые наиболее убедительно продемонстрировали генетическую связь философии и литературы.