Assessment of the Capacity to Express Informed Consent for Organ Donation in Patients with Schizophrenia

Abstract: In Italy, the “silent‐consent” principle of donor’s willingness regulates organ donation for postmortem transplantation, but civil incompetence excludes it. We investigated decisional capacity for organ donation for transplantation of 30 controls and 30 nonincompetent patients with schizophrenia as related to clinical symptoms, cognition, and functioning. Assessments were carried out through the Competence for Donation Assessment Scale (CDAS), Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms, Life Skills Profile (LSP), Raven’s Colored Progressive Matrices (RCPM), Wisconsin Card Sorting Test, Rey RI, Rey RD, and Visual Search. Patients and controls differed on the CDAS Understanding and Choice Expression areas. Patients showed significant inverse bivariate correlations between CDAS Understanding and scores on total BPRS, LSP self‐care scale, and RCPM cognitive test. Our results show that decisional capacity for participating in research does not predict decisional capacity for postmortem organ donation in patients with schizophrenic or schizoaffective psychosis; hence, before judging consent for donation, patients must be provided with enhanced information to better understand this delicate issue.     

15 STR loci frequencies in the population from Santa Catarina, Southern Brazil

Allele frequencies for 15 short tandem repeats (STR) loci were determined with a sample of 3000 unrelated individuals from the population of Santa Catarina, Southern Brazil. The loci are most commonly used in forensic and paternity testing, being analyzed by the Powerplex 16 (Promega) commercial kit. The data shows that most polymorphic loci were Penta E and FGA. The distributions of the genotypes in the evaluated loci are in Hardy–Weinberg equilibrium. Comparative analyses between our population data and other Brazilian populations are presented. The calculated forensic parameters showed that the loci are useful for the solution of forensic problems in Brazilian Southern region.     

Morphometric Investigation of Death by Asphyxia

Abstract:  The aim of this study was to investigate the possibility of distinguishing deaths by asphyxia from those due to natural causes by comparing morphometric measurements in lungs. The study population comprised 27 subjects: 14 cases of death by asphyxia (hanging or drowning) and 13 cases of sudden natural death. Eighty parenchyma sections were used for each subject. Data were collected by computerized image analysis. Measurements aimed at quantifying, as percentages, pulmonary parenchyma (mean values of positive-fraction areas [PFA] and their standard deviations). Subjects who died of natural causes and of drowning showed a relative internal homogeneity compared to those who hanged. Results show significant discrimination between drowned subjects and those dying of natural causes (mean of PFA p  = 0.01) and between hanged and drowned subjects (SD of PFA p  = 0.04). Attention must be paid to the possible role played by senile emphysema. The method is proposed as a complementary tool in forensic cases.     

Co-occurring psychiatric and substance use disorders among male detainees in Italy

This paper presents data on the prevalence of co-occurring substance use and psychiatric disorders among newly imprisoned males in Italy. Interviewers conducted semi-structured clinical interviews with n = 302 male detainees seven days after their admission to the prison of Perugia from August 2005 through July 2006. Over half of male detainees (54.3%) had either a substance use disorder or another psychiatric disorder. One of every five detainees (20.9%) had comorbid substance use and psychiatric disorders. Compared to detainees with psychiatric disorder only, substance use disorder only, or no disorder, detainees with comorbid substance use and psychiatric disorders were significantly more likely to have severe impairment in the areas of employment, substance abuse, family and social functioning, and psychiatric symptoms. Findings underscore the need for careful diagnostic screening at intake, access to treatment during detention, and an effective transition to services at the time of release.     

Data envelopment analysis to investigate the Italian legal system and its reform

This work investigates the Italian judicial system and discusses the designing of a policy reform to boost the efficiency of courts, considering the human resources available as well as the expenditure generated by the process to deliver justice. The authors present the benchmarks and shed light on how policy makers embarking on such a process of reform may be misled by inappropriate model definition. In detail, the authors propose a comparative analysis of technical efficiency (TE) scores computed using data envelopment analysis, adopting the same output (number of settled cases) and two alternative sets of inputs (judicial expenditure and human resources). According to the results, without considering the information extracted from the two complementary benchmark analyses, policy makers might be misled in the reform process. Regarding the elements that affect the performance of courts, it may be possible to improve the efficiency of judicial districts by working on judicial procedures. Hence, these are the domains where interventions by policy makers may prove successful. As for policy implications, the models and benchmarks presented here could be used to devise a reform of the judicial system aimed at enhancing its TE, while also keeping public expenditure under control.     

The new generation of international investment agreements: recent developments in the Asia–Pacific region

Over the past decade, a number of countries in the Asia Pacific region have concluded a new generation of FTAs that liberalise trade in goods and services while also containing investment protection provisions. This paper provides an overview of the recent trends giving special attention to the impact of Investor State Dispute Settlement (ISDS) cases which has influenced the evolution of investment rule-making over the last decade. The paper asserts that investment disputes have influenced the refinement of the provisions of the new generation of investment agreements as well as the inclusion of a series of procedural and substantive innovations in these agreements. *Ambassador of Costa Rica to the European Union, Belgium and Luxembourg. This paper was written on the basis of several research projects in which the author participated, before assuming the current position with the Costa Rican government, as consultant with UNCTAD. However, the opinions and views expressed in this paper do not represent the position of UNCTAD, nor the Government of Costa Rica and fully fall under responsibility of the author.

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Political competition and economic performance: evidence from the Italian regions

We verify the predictions of the theoretical literature on the relationship between political competition and economic performance, holding that, when the predominance of an ideological dimension creates a political rent, the party exploiting it selects lower quality politicians whose policy choices worsen economic performance. We examine the sample of 15 Italian Regions from 1980 to 2002 that exploits the institutional reforms of 1995 as an exogenous shock to pre-existing rents. We find evidence that higher political competition improves economic performance, through the choice of more efficiency-oriented policies.     

An unusual fatal case of accidental asphyxia in a child.

The death of a three-year-old child by asphyctic mechanism is described. The child was accidentally suspended by the neck from a half-opened car window. This report details the form in which the accident occurred. The influence of the type of window and the autopsy findings.