Bereavement in the elderly: the role of primary care

Bereavement in the elderly is a concern to primary care physicians (PCPs) as it can lead to psychological illness such as depression. Most people are able to come to terms with their grief without any intervention, but some people are not. This case highlights the importance of early recognition of bereavement-related depressive illness in elderly people. PCPs need to optimise support and available resources prior to, and throughout, the bereavement period in order to reduce the family members'' burden and suffering.     

Effecten van een integrale wijkaanpak genaamd ‘Even Buurten’ op de (gezondheidsgerelateerde) kwaliteit van leven en welzijn van ouderen

Integrated neighborhood approaches (INAs) are increasingly advocated to support community-dwelling older people; their effectiveness however remains unknown. We evaluated INA effects on older people’s (health-related) quality of life (HRQoL) and well-being in Rotterdam. We used a matched quasi-experimental design comparing INA with “usual” care and support. Community-dwelling people (aged ≥70) and control subjects (n?=?186 each) were followed over a one-year period (measurements at baseline, 6 and 12 months). Primary outcomes were HRQoL (EQ-5D-3L, SF-20) and well-being (SPF-IL). The effect of INA was analysed with generalized linear mixed modeling of repeated measurements, using both an “intention to treat” and “as treated” approach. The results indicated that pre-intervention participants were significantly older, more often single, less educated, had lower incomes and more likely to have ≥1 disease than control subjects; they had lower well-being, physical functioning, role functioning, and mental health. No substantial difference in well-being or HRQoL was observed between the intervention and control group after 1 year. The lack of effects of INA highlights the complexity of integrated care and support initiatives.     

A Market‐Based Framework for Quantifying Displaced Production from Recycling or Reuse

The most significant environmental benefit of recycling or reusing a wide range of products and materials is typically the potential to displace primary material production; lack of displacement significantly reduces the environmental benefits of these activities. Because no consensus method to estimate displacement rate has emerged, environmental assessments have tended to assume that displacement occurs on a one‐to‐one basis. However, displaced production is a complex phenomenon governed primarily by market mechanisms, rather than physical relationships. This article advances the understanding of displacement by presenting a market‐based framework describing the displacement relationship and a methodology for quantifying displacement rate based on partial equilibrium modeling. Using this methodology, a general symbolic equation for displacement rate after an increase in recycling is derived. The model highlights the market mechanisms that govern displaced production and identifies five price response parameters that affect displacement rate. Results suggest that one‐to‐one displacement occurs only under specific parameter restrictions that are unlikely in competitive commodity markets, but zero displacement is possible if secondary materials are poor substitutes for primary materials; displacement is likely to be reduced if secondary materials have inferior technical properties. The presented methodology can be generally applied to any system in which recycled or reused materials are substitutes or complements for primary materials. Implications for improving recycling and reuse efficacy and environmental assessment methodology are discussed, and suggestions are presented for expanding the displacement methodology in future research.     

Constitutionality in Montana: A Decade of Institution Building in the Blackfoot Community Conservation Area

Constitutionality is an approach that addresses how people shape their own institutions and rules for local natural resource use even amidst politically challenging conditions at multiple scales. In this paper we examine thelocal public-private partnership known as the Blackfoot Community Project in western Montana (U.S.A.) and its efforts to forstall increasing social and ecological fragmentation by purchasing and conveying thousands of acres of divested corporate timberlands into various conservation ownerships including a locally-owned community conservation area. Based on a decade of participatory research, we examine the creation and operation of the Blackfoot Community Conservation Area (BCCA)’s key governance institution, the BCCA Council, and its efforts to develop locally supported and effective procedures for two of its most contentious issues: motorized recreation and grazing. The analysis highlights strategies of deliberate and incremental processes of participation, cooperation across property boundaries, experimentation, adaptation, and rule modification to find compromises for combined local social and ecological benefits. The paper concludes with a discussion on the tensions raised between these accomplishments occurring in a boldly neoliberal nation-state and among increasingly heterogenous communities, and ongoing challenges entailed in using the market and private ownership (albeit governed by and for a collective of  local constituents) as a strategy to foster resource ownership and stewardship.     

A New Design of Mental State Classification for Subject Independent BCI Systems

BackgroundBrain Computer Interface (BCI) systems have been widely used to develop sustainable assistive technology for people suffering from neurological impairments. A major limitation of current BCI systems is that they are based on Subject-dependent (SD) concept. The SD based BCI system is time consuming and inconvenient for physical or mental disables people and also not suitable for limited computer resources. In order to overcome these problems, recently subject-independent (SI) based BCI concept has been introduced to identify mental states of motor disabled people but the expected outcome of the SI based BCI has not been achieved yet. Hence this paper intends to present an efficient scheme for SI based BCI system. The goal of this research is to develop a method for classifying mental states which can be used by any user. For attaining this target, this study employs a supervised spatial filtering method with four types of feature extraction methods including Katz Fractal Dimension, Sub band Energy, Log Variance and Root Mean Square (RMS) and finally the obtained features are used as input to Linear Discriminant Analysis (LDA) classification model for identifying mental states for SI BCI system.ResultsThe performance of the proposed design is evaluated in several ways such as considering different time window length; different frequency bands; different number of channels. The mean classification accuracy using Katz feature is 84.35% which is the maximum output compare to other features that outperforms the existing methods.ConclusionsOur proposed design will help to make a new technology for development of real-time SI based BCI systems that can be more supportive for the motor disabled patients.     

The river echoes with laughter: a child‐centred analysis of social change in Amazonia

This article examines radical social, cultural, and political changes taking place in Amazonia from the perspective of indigenous children and youth: a group who, despite their demographic prevalence, have received limited attention in the regional literature. Drawing on fieldwork with Matses people in Peru, I consider how children and youth are playing a critical role in the transition from a hunter‐gatherer, forest‐based society towards a riverine lifestyle that is increasingly engaged in trade, the market economy, and exchanges with chotac, or non‐indigenous people. I argue that by engaging with their surroundings through playing and working, Matses children are becoming affectively attached to some parts of the world rather than others. This represents a purposeful shift from the lifestyle and worldviews of older generations and highlights how children are active agents who shape possible future directions of Matses society and transform the community's relationships with the world. Accordingly, I propose a child‐centred view of social change that seeks to demonstrate the implications of children's creativity and agency for society at large and its future development.     

The apple,the tree,and a space to grow in

The idea for the study presented in Spanish Legacies: the coming of age of the second generation was sparked by the series of unrests from immigrant youths in a number of cities across Europe. The discontent expressed by the young generation of immigrants presented a sharp indicator of how little is known about young people of foreign origin growing up as immigrant residents in Europe, despite their significant number (10 per cent in France, 13 per cent in Spain and 15 per cent in Ireland by 2010). The success or failure of immigrants’ integrational processes, considering cultural factors and language barriers as challenges experienced by immigrants, can have major political and social impact on the regions where they reside. It is these challenges that are investigated in depth, in this book.     

Measuring and modeling patient-specific distributions of material properties in abdominal aortic aneurysm wall

Both the clinically established diameter criterion and novel approaches of computational finite element (FE) analyses for rupture risk stratification of abdominal aortic aneurysms (AAA) are based on assumptions of population-averaged, uniform material properties for the AAA wall. The presence of inter-patient and intra-patient variations in material properties is known, but has so far not been addressed sufficiently. In order to enable the preoperative estimation of patient-specific AAA wall properties in the future, we investigated the relationship between non-invasively assessable clinical parameters and experimentally measured AAA wall properties. We harvested n = 163 AAA wall specimens (n = 50 patients) during open surgery and recorded the exact excision sites. Specimens were tested for their thickness, elastic properties, and failure loads using uniaxial tensile tests. In addition, 43 non-invasively assessable patient-specific or specimen-specific parameters were obtained from recordings made during surgery and patient charts. Experimental results were correlated with the non-invasively assessable parameters and simple regression models were created to mathematically describe the relationships. Wall thickness was most significantly correlated with the metabolic activity at the excision site assessed by PET/CT (ρ = 0.499, P = 4 × 10^?7) and to thrombocyte counts from laboratory blood analyses (ρ = 0.445, P = 3 × 10^?9). Wall thickness was increased in patients suffering from diabetes mellitus, while it was significantly thinner in patients suffering from chronic kidney disease (CKD). Elastic AAA wall properties had significant correlations with the metabolic activity at the excision site (PET/CT), with existent calcifications, and with the diameter of the non-dilated aorta proximal to the AAA. Failure properties (wall strength and failure tension) had correlations with the patient’s medical history and with results from laboratory blood analyses. Interestingly, AAA wall failure tension was significantly reduced for patients with CKD and elevated blood levels of potassium and urea, respectively, both of which are associated with kidney disease. This study is a first step to a future preoperative estimation of AAA wall properties. Results can be conveyed to both the diameter criterion and FE analyses to refine rupture risk prediction. The fact that AAA wall from patients suffering from CKD featured reduced failure tension implies an increased AAA rupture risk for this patient group at comparably smaller AAA diameters.     

The impact of pollen load on quality of life: a questionnaire-based study in Lithuania

Populations worldwide have been increasingly affected by allergic rhinitis associated with pollen allergens. Alterations in the geographical distribution of pollinating flora resulting from climatic changes and increased production of pollens caused by higher atmospheric CO₂, have changed the environment in which humans reside. This study, carried out in Lithuania, aimed to demonstrate how people with pollen allergy are affected by symptoms associated with changing pollen loads and to evaluate the resultant changes in human quality of life. This study assessed pollen loads in Lithuania during 2013–2014. Skin prick tests were carried out on 665 individuals aiming to evaluate sensitivity to pollen allergens. Self-reports on symptoms and their impact on quality of life were collected from each study subject. There were 24× to 42× differences in inter-annual peaks of Betula pollen concentrations, while differences of plant pollen concentrations of the other genus/families varied from 1.5 to 92 % on peak days. Positive reactions to pollen allergens were reported in 54 % of the study subjects; 90 % of these subjects had been continuously suffering from moderate-to-severe symptoms of allergic rhinitis. The most frequently reported symptoms were sneezing (99 %), runny nose (98 %) and stuffy nose (97 %). The dominant group of subjects reported symptoms during the entire period of vegetation (7 months). This study demonstrated that people with pollen allergies have attributed symptom-associated worsening of their quality of life to the typical periods of unavoidable exposure and have made only minimal changes in their lifestyle during the season of pollen load.     

Enhanced phytoremediation of cadmium and/or benzo(a)pyrene contaminated soil by hyperaccumlator Solanum nigrum L.

The role of same amendment on phytoremediating different level contaminated soils is seldom known. Soil pot culture experiment was used to compare the strengthening roles of cysteine (CY), EDTA, salicylic acid (Sa), and Tween 80 (TW) on hyperaccumulator Solanum nigrum L. phytoremediating higher level of single cadmium (Cd) or Benzo(a)pyrene (BAP) and their co-contaminated soils. Results showed that the Cd capacities (ug pot^?1) in shoots of S. nigrum in the combined treatment T_{0.1EDTA+0.9CY} were the highest for the 5 and 15 mg kg^?1 Cd contaminated soils. When S. nigrum remediating co-contaminated soils with higher levels of Cd and BAP, that is, 5 mg kg^?1 Cd + 1 mg kg^?1 BAP and 15 mg kg^?1 Cd + 2 mg kg^?1 BAP, the treatment T_{0.9CY+0.9Sa+0.3TW} showed the best enhancing remediation role. This results were different with co-contaminated soil with 0.771 mg kg^?1 Cd + 0.024 mg kg^?1 BAP. These results may tell us that the combine used of CY, SA, and TW were more useful for the contaminated soils with higher level of Cd and/or BAP. In the combined treatments of Sa+TW, CY was better than EDTA.     

Detectie en preventie van kwetsbaarheid: Op zoek naar risicoprofielen voor fysieke,psychische, sociale en omgevingskwetsbaarheid

In order to provide proactive care and support for older people attention is needed for the prevention of frailty among older adults. Subsequently, accurate case finding of those who are more at risk of becoming frail is crucial to undertake specific preventive actions. This study investigates frailty and risk profiles of frailty among older people in order to support proactive detection. Hereby, frailty is conceived not only as a physical problem, but also refers to emotional, social, and environmental hazards. Using data generated from the Belgian Ageing Studies (N = 21,664 home-dwelling older people), a multinomial logistic regression model was tested which included socio-demographic and socio-economic indicators as well as the four dimensions of frailty (physical, social, psychological and environmental). Findings indicate that for both men and women having moved in the previous 10 years and having a lower household income are risk factors of becoming multidimensional frail. However, studying the different frailty domains, several risk profiles arise (e.?g. marital status is important for psychological frailty), and gender-specific risk groups are detected (e.?g. non-married men). This paper elaborates on practical implications and formulates a number of future research recommendations to tackle frailty in an ageing society.     

Designing future crops: challenges and strategies for sustainable agriculture

Crop production is facing unprecedented challenges. Despite the fact that the food supply has significantly increased over the past half-century, ~8.9 and 14.3% people are still suffering from hunger and malnutrition, respectively. Agricultural environments are continuously threatened by a booming world population, a shortage of arable land, and rapid changes in climate. To ensure food and ecosystem security, there is a need to design future crops for sustainable agriculture development by maximizing net production and minimalizing undesirable effects on the environment. The future crops design projects, recently launched by the National Natural Science Foundation of China and Chinese Academy of Sciences (CAS), aim to develop a roadmap for rapid design of customized future crops using cutting-edge technologies in the Breeding 4.0 era. In this perspective, we first introduce the background and missions of these projects. We then outline strategies to design future crops, such as improvement of current well-cultivated crops, de novo domestication of wild species and redomestication of current cultivated crops. We further discuss how these ambitious goals can be achieved by the recent development of new integrative omics tools, advanced genome-editing tools and synthetic biology approaches. Finally, we summarize related opportunities and challenges in these projects.     

Masking the mask: An Israeli response to the threat of chemical warfare

This paper analyzes a form of visual euphemism which we call “masking the mask.” During the Gulf War, Iraq fired 40 missiles on Israel. Citizens were issued with gas mask kits and were ordered into sealed rooms in their homes during attacks. Thousands of Israelis of all ages decorated or covered their gas mask kits. Although no chemical warheads were fired on the country, Israelis were unusually fearful of gassing because of associations with the Holocaust. Masking the mask served important psychological and communicative functions. It provided a means to express one's fears, to attempt a modest form of mastery over a threatening environment, as well as to rebel against dehumanization and personalization, and to express solidarity with the group under threat, while reasserting one's individual identity.     

The tyranny of the binary: race,nation and the logic of failing liberalisms

This article explores the consequences of rapidly fissuring binary models of community and progress in a national and global context. It suggests that this is a dominant (black/white) paradigm used to map both mainstream and particularly liminal sites of cultural/political articulation. Furthermore, it argues that such models of imputed progress, reason and civility contain the narcissistic residue of an earlier liberal encounter: namely, the fetish quality attached to the black body as abject text and privileged humanist ontology by the twentieth-century European movement of liberal humanism. The article argues that recent attempts to rethink this position vis à vis the European Holocaust have actually rehearsed the logic, both of fetish and binarism. Moreover, that this stasis in liberal thinking on issues of race and violence has heightened the attraction of those political movements characterized by cultural absolutism. The essay suggests that acknowledgement of the 'public secret' which underwrites liberal narrative stasis is the first step towards a more appropriate cultural grammar.     

Brucellosis Causes Alteration in Trace Elements and Oxidative Stress Factors

Brucellosis is regarded as one of the most common diseases among humans and livestock. In the present study, we aimed to assess the effect of this disease on the level of various cations including copper (Cu), manganese (Mn), zinc (Zn), and magnesium (Mg) as well as oxidative stress status in the serum of people suffering from brucellosis. The present case-study was carried out on 40 patients with brucellosis (case) and 20 healthy people (control). Blood specimens were taken from all the people and the level of essential trace elements and oxidative stress status were measured. The serum level of copper in the case group (165.39 ± 43.19 μg/dl) was significantly higher compared with that in the control group (122.12 ± 28.88 μg/dl). Whereas the serum level of zinc was significantly lower in the case group compared with that in the control group (76.47 ± 28.88 vs. 92.85 ± 23.16 μg/dl). The manganese and magnesium serum levels did not differ significantly between the two groups. Furthermore, total antioxidant capacity level was significantly lower in the case group (122.12 ± 28.22 μmol/ml) than that in the control group (3.08 ± 0.12 μmol/ml) and the level of serum malondialdehyde was significantly higher in the case group (7.20 ± 0.23 mmol/ml) than that in the control group (4.0 ± 0.19 mmol/ml). Brucellosis can cause alteration in the serum level of essential trace elements. Moreover, the present study indicated that brucellosis produces oxidative stress in patients.     

PURIFICATION AND CHARACTERIZATION OF AN ALKALINE CELLULASE PRODUCED BY Bacillus subtilis (AS3)

An extracellular alkaline carboxymethycellulase (CMCase) from Bacillus subtilis was purified by salt precipitation followed by anion-exchange chromatography using DEAE-Sepharose. The cell-free supernatant containing crude enzyme had a CMCase activity of 0.34 U/mg. The purified enzyme gave a specific activity of 3.33 U/mg, with 10-fold purification and an overall activity yield of 5.6%. The purified enzyme displayed a protein band on sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) with an apparent molecular size of 30 kDa, which was also confirmed by zymogram analysis. The enzyme displayed multisubstrate specificity, showing significantly higher activity with lichenan and β-glucan as compared to carboxymethylcellulose (CMC), laminarin, hydroxyethylcellulose, and steam-exploded bagasse, and negligible activity with crystalline substrate such as Avicel and filter paper. It was optimally active at pH 9.2 and temperature 45°C. The enzyme was stable in the pH range 6–10 and retained 70% activity at pH 12. Thermal stability analysis revealed that the enzyme was stable in temperature range of 20°C to 45°C and retained more than 50% activity at 60°C for 30 min. The enzyme had a Km of 0.13 mg/ml and Vmax of 3.38 U/mg using CMC as substrate.     

Ungulate browsing shapes climate change impacts on forest biodiversity in Hungary

Climate change can result in a slow disappearance of forests dominated by less drought-tolerant native European beech (Fagus sylvatica) and oak species (Quercus spp.) and further area expansion of more drought-tolerant non-native black locust (Robinia pseudoacacia) against those species in Hungary. We assumed that the shift in plant species composition was modified by selective ungulate browsing. Thus, we investigated which woody species are selected by browsing game. We have collected data on the species composition of the understory and the browsing impact on it in five different Hungarian even-aged forests between 2003 and 2005. Based on these investigations the non-native Robinia pseudoacacia living under more favourable climatic conditions was generally preferred (Jacobs’ selectivity index: D = 0.04 ± 0.77), while the native Fagus sylvatica and Quercus spp. (Q. petraea, Q. robur), both more vulnerable to increasing aridity, were avoided (D = ?0.37 ± 0.11; ?0.79 ± 0.56; ?0.9 ± 0.16; respectively) among target tree species. However, economically less or not relevant species, e.g. elderberry (Sambucus spp.), blackberry (Rubus spp.) or common dogwood (Cornus sanguinea) were the most preferred species (D = 0.01 ± 0.71; ?0.12 ± 0.58; ?0.2 ± 0.78, respectively). Our results imply that biodiversity conservation, i.e. maintaining or establishing a multi-species understory layer, can be a good solution to reduce the additional negative game impact on native target tree species suffering from drought. Due to preference for Robinia pseudoacacia selective browsing can decelerate the penetration of this species into native forest habitats. We have to consider the herbivorous pressure of ungulates and their feeding preferences in planning our future multifunctional forests in the light of climate change impacts.     

Children and the nuclear threat: a child psychiatrist's personal reflections

From the very first stages of life, parents have provided their children with love and protection against harm from within or without, especially from life-threatening situations. Children's perception of death as a unique phenomena develops around age ten and later on, when they begin to grasp the meaning of mortality. This often occurs when they themselves suffer from terminal illness. Children have been the object of destruction, as witnessed by The Holocaust and Hiroshima. The threat of nuclear war poses a new problem for parents, since threatening others is no longer a viable solution to the conflict. In addition, adults manifest a massive denial that the destruction of mankind can take place at any time. This denial, like a family secret, prevents children from asking questions and expressing to their parents their fears about their own and mankind's destruction. Examples are given of how children do express their concerns and fears about the nuclear threat when they are allowed to express themselves. Unless this denial is replaced by open communication about the seriousness of the situation, children and adolescents will view the adults' denial as numbness and folly and as responsible for the world's destruction. A meaningful dialogue between parents and children about the threat is given as the solution to the family conflict.     

Stability and Change in In-Group Mate Preferences among Young People in Ethiopia Are Predicted by Food Security and Gender Attitudes,but Not by Expected Pathogen Exposures

There is broad anthropological interest in understanding how people define “insiders” and “outsiders” and how this shapes their attitudes and behaviors toward others. As such, a suite of hypotheses has been proposed to account for the varying degrees of in-group preference between individuals and societies. We test three hypotheses related to material insecurity, pathogen stress, and views of gender equality among cross-sectional (n = 1896) and longitudinal (n = 1002) samples of young people in Ethiopia (aged 13–17 years at baseline) to explore stability and change in their preferences for coethnic spouses. We show that food insecurity is associated with a greater likelihood of intolerant mate preferences. We also find that young people who hold more gender equitable attitudes tended to hold more tolerant mate preferences. Finally, we find no support for the hypothesis that expected pathogen exposure is associated with intolerant mate preferences. Our results most strongly support a material insecurity hypothesis of in-group bias, which assumes that uncertainty over meeting basic needs leads people to favor those in their in-group. As such, our findings join a small but growing group of studies that highlight the importance of material insecurity for understanding tolerance, xenophobia, in-group bias, and favoritism.