Best Practices from Eight European Dementia-Friendly Study Cases of Innovation.

The concept of dementia-friendly cities and communities has achieved great dissemination in the international context since 2016. Although it is usually related with community networks and services, evidence and guidelines show the close relationship between the built environment design, health promotion, and the preservation of relationships with the local surroundings. Recent publications emphasize best practices in urban areas and care management. However, this is a very complex reality in each country depending on the sociosanitary services, the demographic, and geographic structure and many other different aspects including cultural ones. Moreover, design should also consider not only basic aspects such as habitability or universal accessibility, but also heritage, identity, and the feeling of normalized living. Knowledge about international experiences and innovative approaches is, as yet, an object of study as demographic ageing is still challenging all the welfare systems, especially in Europe. This study presents eight descriptive study cases in three different European countries-the United Kingdom, Belgium, and The Netherlands-to analyze the relationship between dementia-friendly initiatives and their intersection with design, urban planning and the provision of care. The results can provide strategic lines for development and innovation towards dementia-friendly societies and cities achieving SDG numbers 3 and 11 simultaneously.

Radiation and Dust Sensor for Mars Environmental Dynamic Analyzer Onboard M2020 Rover.

The Radiation and Dust Sensor is one of six sensors of the Mars Environmental Dynamics Analyzer onboard the Perseverance rover from the Mars 2020 NASA mission. Its primary goal is to characterize the airbone dust in the Mars atmosphere, inferring its concentration, shape and optical properties. Thanks to its geometry, the sensor will be capable of studying dust-lifting processes with a high temporal resolution and high spatial coverage. Thanks to its multiwavelength design, it will characterize the solar spectrum from Mars' surface. The present work describes the sensor design from the scientific and technical requirements, the qualification processes to demonstrate its endurance on Mars' surface, the calibration activities to demonstrate its performance, and its validation campaign in a representative Mars analog. As a result of this process, we obtained a very compact sensor, fully digital, with a mass below 1 kg and exceptional power consumption and data budget features.

Patient General Condition at Diagnosis: A Systematic Evaluation for Adults Diagnosed with Hematologic Malignancies.

Several societies have published recommendations for evaluating older adults with cancer in standard conditions. It is vital to assure a proper systematic patient condition evaluation, not only in the oldest (geriatric assessment) but in all adult patients. We have investigated the feasibility of a systematic evaluation of the general condition of all patients diagnosed with hematologic malignancies, and the degree of acceptance by the clinical team, in a prospective cohort of 182 consecutive adults, by using the ECOG performance status scale (ECOG, age 18 and over, 18+), Lee Index for Older Adults (LEE, 50+), Geriatric Assessment in Hematology (GAH, 65+), and the Comprehensive Geriatric Assessment (CGA, 75+). Clinical team acceptance was analyzed with a visual analogue scale, and the objective feasibility was calculated as the proportion of patients that could be finally evaluated with each tool. Acceptance was high, but the objective feasibility was progressively lower as the complexity of the different tools increased (ECOG 100%, LEE 99.4%, GAH 93.2%, and CGA 67.9%). LEE and GAH categories showed a weak concordance (Cohen's Kappa 0.24) that was slight between LEE and CGA (Kappa 0.18). Unexpectedly, we found no significant association between the GAH and CGA categories (p = 0.16). We confirm that a systematic evaluation of all adult patients diagnosed with hematologic malignancies is feasible in daily practice by using an age-adapted approach. Direct comparisons among the different predictive tools in regard to patients' tolerance to treatments of different intensities must be a priority research subject in the coming years.

Using a virtual patient system for the teaching of pharmaceutical care.

PURPOSE: The communication skills of pharmacists are essential for the identification and reduction of patient́s drug related problems. Therefore, Pharmacy courses started the process of teaching Pharmaceutical Care to students in order to improve their communication skills. The use of virtual patients (VP) has been a widely used technique in health care courses, but many of the VP tools in Pharmacy field are in English and do not have clinical cases that are common in tropical countries, such as Brazil. The aim of this work is to describe the PharmaVP system, developed with the purpose of training Latin America students in Pharmaceutical Care. The main differential of PharmaVP is the availability in three languages (Portuguese, English and Spanish) and the possibility of clinical case evolution, simulating several visits made by the patient. METHODS: The system was developed according to an incremental and interactive methodology, well suited for conducting multidisciplinary projects. Real clinical cases were collected from a Pharmaceutical Care program and added in PharmaVP to simulate the virtual patients. Then, 31 students of a Pharmacy course were trained and invited to participate of the evaluation study. They used the software and answered adapted instruments that assess the students' acceptance of, use of, learning of, and satisfaction with the system. RESULTS: The results showed that the students found the cases realistic and learned significantly using the software. Another positive point is that the application process of PharmaVP did not consume much time. DISCUSSION: We can conclude that the virtual patient tool contributed to the development of the skills required for the practice of Pharmaceutical Care, but should be used as complementary technique.

O autismo hoje em dia: quais os pontos de apoio institucionais no tratamento das crianças autistas? / Autism nowadays: which are the institutional supporting points on the treatment of autistic chidren

O artigo discute a importância da instituição como terceiro no tratamento de crianças autistas, mesmo quando tratadas pela psicanálise. Apresenta um caso clínico atendido desde antes de três anos, em que houve negativação dos sinais de autismo.(AU)

The paper discusses the institution's importance as the third party on the treatment of autistic children, even when treated by psychoanalysis. It presents a clinical case treated since before three years old where negativation of autistic symptoms occurred.(AU)

O inapanhável objeto do savoir-faire na análise / The elusory object of know-how in analysis

Além das regras técnicas, o savoir-faire (saber-fazer) provém de uma posição ética. O tato, assim como a disponibilidade, o constitui. Ele encontra sua expressão na regra da atenção igualmente em suspenso. Esta visa a impedir a compreensão precipitada e favorece a surpresa no discurso, sinais de uma passagem de inconsciente. Ela também indica que o savoir-faire se encontra ligado ao tempo e ao seu manejo, bem como à existência da lalíngua (lalangue). No entanto, o savoir-faire não deve se situar somente do lado do analista, mas também do analisante. A este cabe aprender como lidar com seu fantasma e seu sintoma. Além disso, o savoir-faire se refere sempre a uma subjetividade, seja ela do analista ou do analisante, na medida em que o inconsciente é um savoir-faire com a lalíngua?(AU)

Over and above technical rules, know-how derives from an ethical position. Tact and receptiveness are its constituent parts. It finds expression in the rule of equally suspended attention which guards against a hasty understanding of what is said, preferring surprises as signs of the unconscious. The rule indicates also that know-how is linked to the notion of time and its handling as well as to the existence of lalangue.?Know-how however is not only in the realm of the analyst. The analysand too must find how to do with his fantasies and symptom. Finally, is know-how always to be attributed to a subjectivity, be it that of the analyst’s or the analysand’s, insofar as the unconscious is know-how with lalangue?(AU)

Isso se transmite de maneira atravessada, a psicanálise / It is transmitted so crossed, psychoanalysis

A singularidade da transmissão no campo da psicanálise passa por outras vias bem diferentes das do ensinamento, da educação e da filiação. Verificamos que existe um antagonismo entre uma tentativa de organizar uma transmissão racional, estabelecida, universitária e alguma coisa que chamamos de “atravessada”. Lacan buscou evitar um modo de transmissão preestabelecido, e o dispositivo do passe foi a proposição elaborada por ele — com o intuito de poder ter acesso a esse saber que concerne à transmissão — e que se constitui de maneira atravessada. A palavra passe evoca uma trans-formação, um processo que passa de um estado a outro. Ele foi revisitado por Lacan diversas vezes, e tais retornos dizem justamente dessa dificuldade em conceber a transmissão. Podemos dizer que existe uma forma de errância na transmissão e que a psicanálise se transmite de maneira atravessada(AU)

Psychoanalytical transmission is rather singular, a quite different of teaching, of education and affiliation. We observed that there is an antagonism between an attempt to organize a rational academic established transmission and something that we call “traversed”. Lacan has always tried to avoid a predetermined mode of transmission, and the pass is one proposition elaborated by him – with the intention of access this knowledge concerning the transmission, which is constituted in a crossed way. The word pass evokes a trans-formation, a procedure that passes from one state to another. It has been revisited several times by Lacan, and these returns are clearly related to the difficulty of conceiving transmission. We may say that there is one sort of wandering in the transmission, that’s the reason why psychoanalysis is transmitted in a traversed way(AU)

Real, simbólico, imaginário: da referência ao nó / Real, symbolic, imaginary: the reference to the node

Por que o ternário RSI é figurativo do borromeano? Partindo dessa questão aparentemente simples, isolamos duas lógicas distintas do trabalho do ensinamento de Lacan, que concernem o ternário: a que diz “da referenciação” e que preside o seu aparecimento em 1953, e aquela dita “nodal”, que surge com a borromenização do RSI a partir de 1973. Qualificamos a primeira de lógica da referenciação devido a sua proximidade com o método cartesiano de coordenadas algébricas de formas geométricas (sistema de coordenadas cartesianas). Mas essa questão não é apresentada sem gerar problemas, e a aparição do laço borromeano em 1973 traz consigo a solução de alguns problemas. Iremos explorar as vantagens e os limites dessa nova apresentação do RSI pelo borromeano e três consistências, para finalmente propor um nó de nove consistências como suporte do RSI. Esse percurso interroga as relações e as intersecções entre a clínica, a nodologia (nodologie lacanienne) e a cientificidade da psicanálise(AU)

Why is the RSI ternary figurative of the borromean? Starting from this apparently simple question our aim is to isolate two distinct forms of logic at work in Lacan’s teachings on the ternary: the so-called marker first mentioned in 1953 and the nodal, which appeared with the borromeanisation of RSI from 1973 on. We describe the first as the logic of marking because of its proximity to the Cartesian approach of algebraic coordinates of geometric forms (the Cartesian marker). This, however, poses certain problems and the appearance of the borromean link in 1973 manages to solve some of them. We thus examine the advantages and the limits of this new presentation of RSI by a triple consistency borromean to propose instead a knot of nine consistencies as a support of RSI. This development raises the question of the connections and cross-checkings between clínical practice, nodology and the science of psychoanalysis(AU)