RESUMO Objetivo: Adaptamos o MacArthur Competence Assessment Tool for Treatment (MacCAT-T) para o português brasileiro, realizando estudo piloto em amostra de pessoas com doença de Alzheimer (DA) leve e moderada. Métodos: O processo transcultural apresentou seis passos. Posteriormente, avaliamos competência para consentimento do tratamento, cognição global, memória de trabalho, consciência da doença, funcionalidade, sintomas depressivos e gravidade da doença de 66 pessoas com DA. Resultados: Os itens apresentaram equivalência semântica, idiomática, conceitual e experiencial. Não encontramos diferenças entre pessoas com DA leve e moderada nos domínios do MacCAT-T. Regressões lineares demonstraram que raciocínio (p = 0.000) e funcionalidade (p = 0.003) estavam relacionados à compreensão. Compreensão (p = 0.000) estava relacionada ao julgamento e raciocínio. Consciência da doença (p = 0.001) estava relacionada à expressão da escolha. Conclusões: A adaptação da MacCAT-T foi bem compreendida e os constructos da versão original mantidos. Resultados do estudo piloto apontaram disponibilidade de ferramenta brasileira sobre tomada de decisões na DA.

ABSTRACT Objective: We adapted the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) to Brazilian Portuguese, pilot testing it on mild and moderate patients with Alzheimer's disease (AD). Methods: The cross-cultural process required six steps. Sixty-six patients with AD were assessed for competence to consent to treatment, global cognition, working memory, awareness of disease, functionality, depressive symptoms and dementia severity. Results: The items had semantic, idiomatic, conceptual and experiential equivalence. We found no difference between mild and moderate patients with AD on the MacCAT-T domains. The linear regressions showed that reasoning (p = 0.000) and functional status (p = 0.003) were related to understanding. Understanding (p = 0.000) was related to appreciation and reasoning. Awareness of disease (p = 0.001) was related to expressing a choice. Conclusions: The MacCAT-T adaptation was well-understood and the constructs of the original version were maintained. The results of the pilot study demonstrated an available Brazilian tool focused on decision-making capacity in AD.

Abstract Our intention, in this article, is to shed some light on the paradoxical fact that Ronald Coase is quoted as a reference both by neoclassical economists as by critics of this school. By appealing to "realism", and introducing institutions into the framework of his analysis, Coase appears as a critic of neoclassical theory. But. in the result he is most famous for -the so called "Coase Theorem" -he relies heavily on certain elements of the very theory that he is supposed to be critical of, namely the assumption of "efficiency of the price system". And he does not seem aware of the dependency of his result upon this assumption.

Resumen Este artículo se propone situar el origen de la "paradoja" que constituye Coase, cuya obra sirve de referencia tanto a los neoclásicos como a los que los critican. Coase dice criticar los primeros, en nombre del "realismo", al darle importancia a las instituciones. Pero en el resultado que lo hizo famoso, llamado corrientemente 'Teorema de Coase", se apoya de manera decisiva sobre la teoría que critica -especialmente la idea de la eficiencia del sistema de precios- sin darse cuenta de ello, por lo menos aparentemente.